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Boston 

Medical Library 

S The Fenway. 






Collected Papers 



OF 



Margaret Bancroft 



ON 



Mental Subnormality 

and the 

Care and Training of 
Mentally Subnormal Children 



PHILADELPHIA 

Ware Brothers Company 

1915 



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/4, (Ai^f-'J 



A US'! 1918 




INTRODUCTION 

ARGARET BANCROFT was a pioneer in the 
field of education for mentally subnormal 
children. At the time that she began her 
work these children were rarely given any 
special training. In fact but little attention 
was paid even to their proper housing and care. The prob- 
lem, like many of the social problems of the day, had 
existed for generations without attracting attention. Society 
had not yet awakened to its importance. 

To hasten this awakening was one of Miss Bancroft's 
dearest aims. She understood subnormal children as few 
others have ever understood them ; she saw their helpless- 
ness, their utter need, and she was filled with a great zeal 
to make the world see the problem as she saw it. She 
preached the gospel of freedom for subnormal children, 
freedom from neglect and contempt, freedom from inade- 
quate teaching, freedom from physical defects and dis- 
abilities. This was her cause; she made herself its 
champion, and for this championship she will be chiefly 
remembered. 

The following papers by Miss Bancroft have been 
gathered together in the belief that their publication in the 
form of a little book will be welcome to many. They embody 
all that she wrote regarding her work, and cover the period 
of her most active professional life, between the years 1892 

3 



and 1909. The volume seems a small one to epitomize the 
experience of thirty years, but an attentive reading will 
show that the fundamental aims of her educational work 
are all set forth. 

The papers are reprinted without change except for the 
correction of a few minor and obvious errors, and such 
slight alterations as were needed to secure uniformity. No 
attempt has been made to avoid the repetitions that of 
necessity appear in addresses upon the same topic delivered 
before audiences of similar character. 

The chronologic arrangement has been chosen because it 
enables the reader to trace the growth of some of the most 
important of Miss Bancroft's teachings as they developed 
in her own mind. For example the idea of a personality 
may be seen to unfold from vague beginnings to a definite 
concept; technical terms which were used freely in the 
earlier papers disappear later, because of an increasing anti- 
pathy to any word or phrase suggestive of disparagement 
or contempt ; the theory of "home" environment, as distinct 
from institutional life, will be found to grow into a concrete 
plan, embracing state as well as private schools, and hospitals 
for the insane as well as institutions for the subnormal. 
Other ideas will be observed to pass through a similar 
evolution. 

But the dominant note throughout all the addresses is 
the note of appeal — appeal to an unawakened and seemingly 
unresponsive public — for understanding, sympathy and lov- 
ing help for subnormal children. That the public was not 
wholly unresponsive the signs of the times give abundant 
evidence. The importance of appropriate care and training 
for the mentally subnormal is being recognized by many 

4 



intelligent people. Gratifying results are to be expected in 
the near future; and when the history of educational prog- 
ress during the present time comes to be written, the name 
of Margaret Bancroft will find in it an honored place. 



E. A. Farrington 



Haddoniield, New Jersey 
December, 1914 



Digitized by the Internet Archive 

in 2010 with funding from 

Open Knowledge Commons and Harvard Medical School 



http://www.archive.org/details/collectedpapersoOObanc 



CONTENTS 



PAGS 

I. Two Cases of Individual Training 9 

11. Methods and Results in the Care and Training of 

Backward and Deficient Children 17 

III. Hints on the Care and Training of Mentally and 

Morally Deficient Children 31 

IV. The Claims of the Feeble- Minded 42 

V. Classification of the Mentally DEFiaENT 47 

VI. Light Through Broken Windows 60 

VII. Home Care of Children Who are Backward and Men- 
tally Deficient ^7 

VIII. Presidential Address 76 

IX. The Child Who Hears, Yet Cannot Talk 81 

X. The Mind of the Subnormal Child and Its Liberation 89 

XI. The Leakage in Our Educational System 96 



AUG 5 1918 

4Lbra^ 
I 

TWO CASES OF INDIVIDUAL 
TRAINING* 



THE two pupils of whom we will give brief reports 
to-day are not both cases of surgical interference. 
The one of whom we will speak first is a deaf-mute, 
and so marked a case of idiocy that we feel we should like 
to make known what can be done for such a one with syste- 
matic individual training. In the summer of 1887 S. E. 
was brought to us, past twenty years of age, a sickly, wild, 
destructive, disgusting piece of humanity. With his eyes 
rolling, his head never still, his unearthly noises, his vomit- 
ing, his sniffling, and with a poor worn-out stomach, he cer- 
tainly seemed not only a hopeless case, but appallingly 
hopeless. Neighbors asked where we kept the cow that 
bellowed so, the children who passed looked in trembling 
eagerness to see the wild man, while all our attention was 
given to keeping him from breaking away and destroying 
the furniture. The only gleam of hopefulness to us in the 
case was his homesickness and the strong affection he 
showed for his family. 

During the first few months our efforts were directed 
to getting him physically well; indiscriminate eating and 
drinking had almost destroyed the coating of his stomach, 
consequently even after drinking he would vomit. After 
months of weary effort in dieting we were rewarded ; and 
our record, twelve months after his coming to us, showed 

* Read before the Association of Medical Officers of American Institu- 
tions for Idiotic and Feeble-Mindcd Persons, I^Iwyn, Fa., June isth, 1892. 
See Proceedings A. M. C, 1892; p. 331. 



that "S. E. went four days without vomiting or destroying 
his clothes." During that year we had tried male and 
female attendants. All left in disgust with their failure; 
and finally we decided that if we were to win in the race 
we must take entire charge day and night. This I did for 
three months. I slept in the same room with the boy, 
tended and cared for him, taught him to love me and to 
feel that I loved him. From that time the greatest trial 
was over. In the summer of 1888 Miss Cox entered into 
the work with me, and she noticed that he was fastidious 
about the color of things he wore, and suggested having 
nice clothing for him, white shirts, collars, neckties, etc. 
His people were willing, but laughed at the idea. We 
tried it; we took him to Philadelphia and had him fitted 
for his suit. The success was wonderful. He was per- 
fectly delighted, blew and pufifed on his clothes (a sign 
of pleasure), and from that time, unless some very serious 
trouble arose with his caretaker, he never destroyed any- 
thing he wore unless it was ugly. Previous to this he 
would destroy or tear three or four suits a week. We took 
him to the Philadelphia Academy of Music at one time, 
and he behaved beautifully and appreciated the play. We 
desired to have his picture taken, but so far it had been 
impossible; but we showed him how much we wanted him 
to be good, and after he had been with us two years we 
took him to Philadelphia to a photographer's and he had 
a good picture taken. 

It seemed impossible to secure his attention, and after 
a year we had barely succeeded in getting him to string 
buttons and beads, and this only for a short time, his 
favorite pastime being to rock in a chair. In the fall of 
1888 we had him sufficiently under control to place him 
in the schoolroom to have the discipline of sitting still 
during the opening exercises. Miss Cox, who had charge 
of him, made him draw strokes with a carpenter's pencil 
in a book or on a slate, and with chalk on the blackboard ; 



10 



for every mark he did well he received a small piece of 
cand}', and for every wilfully wrong mark a tap on his 
knuckles with a ruler. In 1889 and 1890 mat-weaving 
was added to the drawing of lines. It would be impossible 
to count the dozens of mats destroyed and the weaving 
needles broken and the taps on the knuckles, etc., etc., but 
at last patience was rewarded, and the whole school set up 
a hurrah one morning when S. threaded his needle and 
wove one row without help. There were many ups and 
downs, but from that time the improvement was constant 
until it became a matter of course for S. to finish a mat 
in two or three lessons. A peculiarity of his was always 
to choose delicate pinks, blues and grays, never showy 
bright colors. We had a set of stencils for him, and tak- 
ing a hint from Laura Bridgman, had him print the words 
and get the articles; for example, cake, knife, water, cup, 
glass, key, etc. He was very fond of riding, and great 
was his glee when he could print "horse," and then take 
the paper to the man at the stable to show him he was 
to have a ride. His lessons the last year consisted of kin- 
dergarten drawing, weaving, pricking, pinking, drawing 
objects in Krusi's Drawing Books, Nos. i and 2, printing, 
carpentry, of which he was very fond, hammock-making, 
and we were about having him taught shoe-making, as he 
had a great aptitude for tools. 

A large number of people have heard and seen this 
boy before and after coming to us, and all wonder at our 
great success. It has taken unbounded patience, hopeful- 
ness and trust, but the great secret has been love — our love 
for him and his love for us and trust in us. We tried 
two or three times placing him in the care of others to be 
taught, when we were engaged with a new pupil, but the 
experiment always failed, as none loved or thought it 
worth while to try as we did. 

This holds good for all feeble-minded children. The 
only truly successful teachers and helpers in this work are 

II 



those who adopt it from love of it and not from desire 
for gain or fame. 

The second case we have to rej>ort is one involving 
surgical interference, and is perhaps the most interesting 
of which we have any record. W. P. is reported as being 
an unusually bright boy until at fourteen months of age 
he had a fall of ten or twelve feet, after which there was 
a change in his mental condition, though no outward in- 
jury could be observed. At the age of two and a half 
years, during a slight illness, his first attack of epilepsy 
occurred, and from that time until Dr. W. W. Keen, of 
Philadelphia, operated upon him, four years later, he had 
over five thousand spasms. He was so dangerous that he 
was confined in a little room made and padded for him. 
His clothing had to be sewed on him every morning, as 
he would tear it off if it was put on in the ordinary way. 
Any animal or fowl which strayed into his little yard, such 
as a cat or chicken, etc., was instantly killed. He knocked 
down and kicked one of his caretakers. He could climb 
so quickly that his father said he had frequently been to 
the top of his church, and in such a position that it would 
make a spectator tremble with fear. It was a heart-break- 
ing trial to his father and mother, and although every- 
thing was done to help him, and large sums were spent 
with different physicians, all was in vain until he was 
brought to Philadelphia to Dr. Keen and was operated 
upon at the Jefferson Hospital in December, 1889. Tre- 
phining was performed and the brain centre controlling 
the right hand was removed. His father stated to us, 
when he brought the boy to our home in March, 1890, 
that after the operation there was some slight improve- 
ment, that by watching him he could be kept for a time 
with other children without hurting them, and would not 
tear off his clothes as he had done before operation. His 
spasms had decreased in number, although he had had 
several setbacks, such as a bad fall, and no systematic 



training. For some time after his arrival we felt we had 
a young tiger in our peaceful home; he bit, scratched, 
kicked, and spat on us until we were black and blue and 
dripping wet with saliva. This is no exaggeration ; I have 
seen him wet four persons who were trying to help get 
him under subjection. In his paroxysms of spitting we 
felt that he was no imbecile, for he deliberately aimed 
his spitting at the person who was doing the most to con- 
quer him. This encouraged us, and we felt we would try 
to find if there was a possible means of winning our way. 
After much hard work, and after the trial and abandon- 
ment of many methods, we finally succeeded in curing the 
habit of spitting. 

The first attempt to have him at table resulted in the 
plates being thrown across the room and the table upset. 
He would eat nothing but meat, and that with his fingers. 
He seemed to have no taste at all, and in this respect we 
had to cultivate an appetite for all ordinary and healthful 
food. His right hand was partially paralyzed, and we 
were desirous of bringing it into action. This required 
the utmost patience and tact, as we were afraid to use too 
firm measures, on account of the danger of over-exciting 
him and thus bringing on the spasms, which now occurred 
semi-monthly. In this work we had him sit by Miss Cox, 
for whom he began to show the first spark of affection, 
and at each meal, when he could remain, she took his sick 
hand and had him eat one spoonful, holding the spoon in 
the hand; if he would do this he could eat the rest of his 
meal with the other hand. This was persevered with for 
weeks and months, and now he eats with his right hand 
and behaves like a little gentleman. We are very proud 
of his table manners. 

During the first year his spasms averaged between ten 
and fifteen per month. We could not secure his attention, 
and the only amusement he had was a string, which he 
would blow; but in no way could he be induced to play, 

13 



or look at books, pictures, etc. The first attempt to have 
him in the schoolroom was a tempest; we tied him in a 
chair, and a strong man and myself held him there for 
five minutes at a time, and then removed him. We per- 
severed in this for weeks, until we could keep him during 
the opening exercises, tied in his chair. After six months 
of this work we could have him in the schoolroom untied 
for a short time. It was so with everything we attempted 
to do with him; in teaching him we were obliged to have 
one person hold him while another directed his hands. So 
on until we gradually got him to like his work. In march- 
ing, calisthenics, games, kindergarten-work, chart-work, 
board-work, slate-work, there were the same battles week 
after week ; but now he leads in the marching, and we have 
with us his books of work and some work which he did 
in a few minutes. He is trying in all his work to use his 
right hand, but it is a great effort and requires the exer- 
cise of patience on his part. He is loving and neat, takes 
great pride in his clothes, says his prayers and tries to please. 

When he came he could say about thirty words, but 
would not repeat them with any sense. We worked a long 
time before we could get his mind sufficiently under con- 
trol to have him talk, but now he repeats every word he 
hears and tries to make sentences, but is backward in 
this respect. This morning he made a new effort at a 
sentence. He saw me as he came from his bath, and said, 
''Good morning, mamma ; see, Willie been in tub for bath." 
He has a daily drill in asking questions and in answering. 
In this, however, he is very slow, but is now commencing 
to ask a question occasionally, and answers a few. So 
far, although he has a wonderfully strong will, he has 
not acquired the power of bringing that will into play to 
practice the knowledge which he is gaining. To guide 
and direct him in this we feel will require the penetration 
and tact of a Pestalozzi or a Froebel. 

From January until June, 1891, he had fifty-three hard 

14 



spasms. From January, 1892, until the present time (June, 
1892), he has had eleven, and three dizzy spells. 

How we wish we could have the public see the neces- 
sity of having more teachers — bright, intelligent teachers 
— in this work, and of establishing training schools for 
teachers and attendants all over the country! When the 
public awakens to this necessity for the feeble-minded and 
backward as it has for the deaf and blind, then and only 
then will we see the results which can be attained. 



Discussion of Miss Bancroft's Paper by Dr. W. W. 
Keen, Professor of Surgery in the Jefferson Medicai. 
C0TJ.EGE, Phii^adei^phia. 

I am happy to say a word with reference to the cases 
Miss Bancroft has reported. The first one was sent to her 
through my efforts. I can bear witness to the most abso- 
lute beastliness of the case. It cannot be described in 
othtr terms. His habits were of the most disgusting char- 
acter, far more than she would feel at liberty to state. The 
improvement has been marvellous. I could never have 
dreamed such an improvement possible, had I not wit- 
nessed it. 

The second case was that of a boy whom I trephined. 
He had been an epileptic four years, from the time he was 
two years old. He had had on an average from three to six 
epileptic seizures a day. I had him in the hospital for 
some time in order to observe him with care. I was not 
willing to operate upon the child until I had determined 
absolutely whether all of the attacks did begin, as asserted 
by his father, in the right hand. This was certainly the 
case in a large number of the attacks in the hospital, and 
I verified the statement that there were three to six in 
a day. His habits were very perverse. Three times in 
the first examination that I made in his case he spat in 
my face so quickly that I was not able to protect myself, 

15 



and his father gave me the same account that Miss Ban- 
croft has given as to his violent habits. 

Having determined the fact that almost all of his 
attacks began in the right hand, although the history of 
the injury to his head was indefinite, I thought I had suf- 
ficient reason for removing the right hand-centre. It was 
one of the earliest operations of the kind that I made. 
This portion of the brain was taken out, and the history 
that you have heard to-day shows what an immense im- 
provement has followed. You must remember that there 
are two factors in this improvement, one the educational 
influences to which he has been subjected, the other the 
surgical element in the case. At the time he was seized 
with epilepsy his vocabulary amounted to forty words. 
But he lost them gradually, word by word, till he had come 
down to but three words when I saw him, "papa," 
"mamma," and, characteristic of his perversity, the other 
word was "no." He has since attained a very large vocabu- 
lary. This began before he was subjected to the educa- 
tional influences that have been so marked. But the point 
I want to call special attention to is this : While we think 
his mental development has been largely due to the edu- 
cational methods, yet by no possibility can we conceive that 
the change in the epileptic attacks has been due to that. 
We all know epileptics who have gone from childhood to 
adult life with educational surroundings of the best, yet 
their epilepsy has remained stationary or grown worse. 
But in this case the attacks, instead of being three to six 
per diem, are now reduced, as you have heard, to only 
eleven within the last six months; as many as he would 
have had in three days before the operation. This I can- 
not believe to be due to his education. His mental devel- 
opment, I think, has been chiefly due to his education, and 
hence I would strongly urge that all epileptics, especially 
those who have submitted to operations of any kind, should 
be subjected to such training. 

i6 



II 

METHODS AND RESULTS IN THE 

CARE OF BACKWARD AND 

DEFICIENT CHILDREN* 



AS I Stand here to-day, for the first time confronting 
a large pubHc audience, I naturally feel reluctant 
to present a subject which is to many, I know, not 
one to awaken interest. But I feel assured by the expres- 
sion of your earnest faces that I shall be able to arouse 
your tenderest feelings and I hope, before my talk is fin- 
ished, that a magnetic wave of sympathy will extend round 
this circle of workers, representing, as you do, our vast 
country — North, South, East, and West. And I trust all 
will have a renewed or awakened personal concern in the 
thousand little helpless ones who to-day require more care, 
more sympathy, more tact, and more scientific instruction 
than the blind, deaf, or any class of unfortunates, who, 
by some error of omission or commission against the laws 
of nature, have been brought into the world in an imper- 
fect state. 

Dr. Wattson tells us "as the light of the sun colors 
the tiniest blade of grass, so the idea in the background 
of the mind tinges every detail of life." It will be my 
object to make you feel that under every human form, no 
matter how repulsive in appearance or abnormal in shape, 
is the idea which at some time will be tinged by the light 
of the Heavenly Father's love. And gradually, as the sun 
in nature brings color to the tiniest blade of grass, the 

* Read at the Second Annual Meeting of the National Congress of Mothers, 
Washington, D. C, May, 1898. 

17 



radiance of love will bring life and color to the idea hidden 
behind the unattractive surface. 

First, in considering the characteristics of these back- 
ward and mentally deficient children, we must distinguish 
between the nervous and the mentally deficient. The ner- 
vous child is found in all our schools, both private and 
public, and is known by the imperfect state of nutrition 
shown by limbs imperfectly developed while the face fre- 
quently indicates good health. The powers of attention 
and concentration seem to be lacking. Although the child 
is frequently very bright and talkative, he is at other times 
quiet and reticent. The nervous child is often undevel- 
oped in size and without symmetry of limb. Other 
characteristics are poor eyesight, and frequent spells of 
irritation, falsely attributed by unintelligent parents and 
teachers to temper or stubbornness. Many such children 
are compelled to spend later years in asylums, institutions 
or prisons; for in many instances the physical lack engen- 
ders and develops more deficiency. 

Why do such appalling results follow so insignificant 
a cause? Because untrained mothers are not wise enough 
to take the child, when these first signs appear, to a good 
physician and find out the cause; secondly, because we do 
not force our medical institutions to make their graduating 
course so high as to prevent incompetent physicians from 
swarming the country, and through indifference or ignor- 
ance advising parents in such a manner that these chil- 
dren are literally neglected until the case becomes hopeless 
insanity, epilepsy or moral deficiency. In hundreds of 
cases this calamity might be averted and the child grow 
into a healthy man or woman and a respectable citizen. 
Do not make your children self-conscious, but observe care- 
fully every sign of nervous exhaustion. Even if it involves 
placing him in a lower grade at school, see that the child 
has sufficient rest to recuperate the nerve cells, proper nutri- 
tion, good nourishing food given at regular times. 

i8 



Proper clothing is another essential to these naturally 
weak, nervous children. Even in hot weather there should 
be a little wool in the underclothing. Care of health does 
not necessarily imply giving up mental training; but de- 
mands only physical care, watchfulness, plenty of fresh 
air, especially in schoolroom or bedroom, brightness and 
pleasant surroundings. All this should be provided in the 
school, since many of these children come from parents 
who have not the means or time or ability to observe their 
physical condition. If our school session could be managed 
in a way to give children, at the end of every hour, a period 
of rest and change of air, much of the nervous strain would 
be removed. 

The age when children should have the least mental 
strain is the one in which, in our large cities, they have the 
most, viz. : the years between fourteen and nineteen. The 
physical and nervous strain on our girls is appalling. No 
wonder our institutions for feeble-minded children and 
insane are increasing at such a rate. A large percentage 
of girls are unfitted at this period by cruel work, particu- 
larly in our public schools, for ever being capable of the 
duties of maternity. Here we have the first cause of the 
truly mentally deficient child. 

I shall now attempt to show you, without going into 
pathological detail, a few causes which will assist us in 
following out the subject, if you feel inclined to go deeper 
into the matter. 

First, in referring to the congenital causes of mental 
deficiency, we find a further division, endemic, hereditary 
and parental. 

Endemic cases are those due to some condition pecu- 
liar to specific localities. Take as an illustration the 
cretin. There is the cretinism due to locality, as that 
of the Alpine or Lowland. But this form of mental 
lack is not always due to geological conditions. It 
may arise from a scrofulous condition of the parent. 

19 



The disease as it exists in the Lowlands of central Europe 
or in the Alps, in Belgium or in Virginia, is due to locality, 
and is marked by the goitre and dirty straw-colored skin. 
But we have also the furfuraceous cretin, whose skin is 
milk-white and rosy, yet constantly peeling. The extremi- 
ties are shortened and the truncated fingers and nose wear 
an unfinished aspect. The lips are cracked and the tongue 
deeply furrowed. Great care must be given to the skin 
in cold weather, as it will become chafed without the slight- 
est cause. The mucous membrane of the eyelids and eye- 
balls protrudes to supply the curtailed skin at the margin of 
the lids. This redness of the eyes gives to the poor cretin a 
very repulsive appearance. Can we think of this affliction 
and have anything but the tenderest sympathy for the suf- 
ferer? No feeling of repulsion should be allowed to take 
root in the mind. We do not necessarily have broncho- 
cele with cretinism, and bronchocele may exist without cre- 
tinism. But I would advise every mother who sees the 
first sign of the goitre to give special care to the physical 
condition of the child. Plenty of suitable exercise, food 
likely to build up the nervous system, systematic mental 
training, and the general advice of a first-class physician 
are all important. Mental deficiency has been traced in 
some cases of goitre, even where it has not been detected 
at once by physicians. This may later develop into in- 
sanity or some other form of mental trouble, which, if the 
case be attended to early in life, may be averted. 

Of the hereditary causes, at which we next glance, I 
may surprise you by saying I have less fear than of the 
parental. Of course you all know of families where in- 
sanity, feeble-mindedness, scrofula, tuberculosis, etc., have 
existed to such a degree as to be marked. Such cases occur 
most frequently where there have been intermarriages. 
But in almost all cases of inherited tendencies, we firmly 
believe, if parents were well versed in the laws of nature, 
and watched the child from birth, such conditions could be 



20 



avoided. The inherited weakness may be there, but will 
require an exciting cause to develop it. And if the proper 
measures can be brought to bear to avert that cause, should 
we not utilize them? I cannot see why a child should 
necessarily inherit disease from former generations, but I 
believe it depends largely upon the ability of the mother 
and father to combat that inheritance. However, what may 
be done in the future has not beeti done in the past, and 
we have bad results from impure blood in our forefathers. 

Resulting from this cause we have the microcephalic 
type (the smallhead). This feature is not always the sign 
of a weak brain, but in many cases it is accompanied by 
poorly developed brain tissue and sometimes by intracranial 
pressure. This brain pressure produces an almost helpless 
case of mental deficiency. No two cases of this kind seem 
to be alike, and although science in later years has devel- 
oped skilled surgery to bring relief, we have not found 
any case which has been permanently helped. We think 
if such cases could be known at birth and during infancy 
a systematic manipulation be given the head, together with 
salt-baths and certain physical movements, much could be 
done and perhaps the patient cured. Such care is not given 
for the reason that parents are loath to acknowledge any 
such deficiency until it is too late to do much, and physi- 
cians have not as yet given this form such study as we 
hope they will in the future. We have noticed in cases of 
epileptics that a certain rubbing of the head and gentle 
movements will at times bring relief. Of course rubbing 
could scarcely influence the closure of the cranial sutures, 
but in infancy I beheve the skull might be expanded if 
treatment were commenced at once, and continued scien- 
tifically for the first three years. We have noticed that 
children afflicted with this trouble have been the offspring 
of families where eczema or tuberculosis has prevailed. 

Under the hereditary caption we note also hydroceph- 
alus or dropsy of the brain, frequently caused by scrofula 



21 



or tumors pressing upon the brain, and often developed 
before the child is bom. 

To parental causes of weakness of intellect the majority 
of cases must be assigned. In our fifteen years of experi- 
ence, so far as I can judge, the parents are for the most 
part responsible, and in many cases, I am sorry to say, the 
trouble can be traced to the mother. It is very easy to 
place our shortcomings^ on our grandparents, but I believe 
with the parents lies the responsibility. Improper conduct 
before marriage, overwork or lack of care during preg- 
nancy, cause helpless little ones to enter the world in any- 
thing but a normal state. Dr. Seguin attributes this result 
largely to the lives of unhealthy excitement which young 
girls lead at the period when they should be built up phys- 
ically, mentally, and morally, by proper food and study and 
away from such excitement. How else can they become 
fitted for the duties of maternity? Our public schools may 
do more harm in this respect than society. Much insistence 
is placed nowadays on the physical development of women ; 
but is this not frequently attended by excitement? Almost 
all women to-day live in too much of a whirl. It is hard 
to find the golden mean between an exclusive home life 
and a society life often full of excitement. When mothers, 
teachers, and guardians shall find this via media, so that 
our girls become strong, healthy, well-poised women — 
then, and then only, can we expect to see babies coming 
like fresh flowers, perfect from the hands of the Maker. 
You will naturally ask whether the fathers have nothing 
to do in the matter. Men are what we make them. They 
will be as good and pure as we expect. If woman- 
kind advances to a higher plane of morality, breaking down 
all false pretences, men are bound to reach the same 
goal. 

Development may also be arrested by traumatic con- 
ditions existing before birth or afterwards due to careless- 
ness of nurses. Sometimes a protracted confinement is the 



22 



cause, or the improper use of instruments at birth. Whoop- 
ing cough, measles, diphtheria, and other infantile diseases, 
sometimes produce brain trouble unless proper care be 
exercised. These and other conditions productive of brain 
disease might be averted if young women could enter the 
marriage state perfectly equipped, determined to know and 
do all that will aid them to bring into the world healthy, 
bright children. 

With such reflections upon the causes of mental weak- 
ness, it is natural to ask what is being done for the improve- 
ment and comfort of these, the least of God's little ones. 
Whatever the cause of trouble, we find the child is not re- 
sponsible and should therefore awaken not only our pity, 
but our tenderest sympathy. Although the mother and the 
father may neglect their duty to the child, our tender, lov- 
ing Heavenly Father gives to these little ones an extra 
gift, as it were, of spirituality and tenderness. They illus- 
trate as no other children the text, "of such is the kingdom 
of Heaven." Their faith, trust, and love are beautiful, and 
mutely demand for them the same rights, and greater rights, 
than any other class of afflicted children. Sadly enough, 
however, they are often the last to receive attention. 

• Although we have large institutions for the care of the 
poorer classes, they do not provide home life, the individual 
study and watchfulness which alone can give to the public 
the greatest obtainable results based upon scientific train- 
ing. The condition of these children is no more degrading 
than that of children with weak hearts, weak lungs, defec- 
tive hearing or poor eyesight. I once heard it said that it 
were well to wish them all dead. If that wish were fulfilled, 
how many of you to-day would have any children alive? 
How many parents have normal children? These little 
ones are peculiarly endowed with the spiritual life, and with 
all due respect to the new psychology, we have been able 
by our close contact with them to see that their abnormality 
is not primarily of the mind, but of the body. The broken 

23 



or imperfect mirror cannot clearly reflect, the defective 
instrument cannot give utterance to tone. 

Only when epilepsy, hysteria or some cruel nerve pres- 
sure produces a highly nervous state, do we find anything 
hurtful or unkind in these children. Remove the pressure, 
give physical relief, and at once we have again cheerful, 
sunny, tractable children. 

How best to reach the mere germ of mentality lying 
dorm.ant in these poor little bodies, how "the sun may get 
to the blades," has been the thought and care of such good 
and great men as Guggenbuhl, Seguin, Brown and Kerlin. 
They have felt that this is to be accomplished only by the 
closest contact and a firm and loving discipline, such as our 
large institutions cannot possibly provide. In many of the 
handsome buildings bearing the name of "State Schools," 
it is a deplorable fact that only a small percentage of the 
inmates attend classes. The others, it is contended, do 
better at domestic or farm work. But if it is necessary to 
put the mentally deficient to manual work at such an early 
age, would not the same principle apply to the blind and' 
the deaf? The excuse rests upon the insufficient means 
to furnish a proper number of teachers for the great num- 
ber of children in the institutions. With sufficient appro- 
priations it would be possible to grade the pupils and so 
report mental progress. No one teacher can do justice to 
twenty feeble-minded children. Twenty pupils, all nervous, 
restless from physical causes, each taking mentality from 
the teacher, leave her little power to inspire or instruct. 
Exhausted by the effort to keep proper discipline, in giving 
out the day's task in a merely mechanical way she is doing 
more than well. To help these children, it is necessary to 
search and search for the first sign of mentality, by object, 
talk, or loving care, line upon line, until the next step is 
reached. How necessary then is it for the teacher to be 
fresh and young and of strong mental resources, if she 
is to arouse any dormant faculty in the pupil. European 

24 



institutions are ahead of us in grasping and emphasizing this 
limitation of number. The best schools there do not allow 
more than eight or ten pupils to a teacher, and in number 
work (on which they lay great stress) only four pupils in 
a class. When our public shall be aroused to demand this 
condition in our state schools it will be possible to ascertain 
what can be done. Another requisite is a state law for the 
castration of all males positively proved to be mentally 
incapable, before the age of puberty, in order to prevent 
subsequent suffering and sin. 

I would suggest that our schools be so arranged for a 
small number of pupils, not exceeding one hundred, and 
that this hundred be divided into groups or families of 
twenty. In making this division those helpful to each other 
should be selected for each family. A schoolhouse entirely 
separate from the homes should be provided for class pur- 
poses. And the classes should be graded according to the 
advancement of the children. The children would then 
at fixed times meet in the same way and with the same 
incentives as normal children. Proximity to a good city 
or town is desirable to insure the interest and oversight of 
the public. One of the worst calamities for the insane or 
the feeble-minded is to be isolated. A non-resident physi- 
cian brings from the outside an impetus of fresh forces 
into the lives of the patients and preserves his own interest 
by avoiding the influence of daily contact with the pupils. 
A resident physician should be maintained only for cases 
where it is impossible to get an outside physician. The 
insane too would be wonderfully helped by this arrange- 
ment. As a thinking public we should endeavor to provide 
that all children mentally deficient should be sent early to 
some school or institution, because in early years the im- 
pressions are more easily made and work will be more 
telling. 

With great pleasure I comply with the request that I 
give some account of our work in Haddonfield. After years 

25 



of uphill work, we have now what we feel is an almost 
ideal school. As yet we have neither a little school build- 
ing separate from our main building, nor have we a sea- 
shore cottage for periodical changes; but we hope to have 
both in the near future. Although our school does not 
exceed eighteen pupils, our entire family numbers forty- 
three. Our teachers, as far as possible, are trained for 
their particular branches of work. For the physical care 
of the little ones outside of school, we have bright, cheer- 
ful, ladylike attendants. In our domestic service we en- 
deavor to have dress and appearance neat and attractive, 
so that the eye will as far as possible see nothing discordant. 
For their physical upbuilding good food properly prepared 
is served at tables and in a dining-room tastefully arranged. 
Ourselves, teachers and attendants, eat with the children, 
in order to see and know all pertaining to the welfare of 
those entrusted to our care. 

We endeavor to surround them with everything that is 
beautiful, everything that will appeal to the artistic sense. 
Both in winter and in summer our home is decorated with 
flowers and growing plants. We extend this theory to pic- 
tures and pretty objects in the bedrooms and appeal for 
pretty and tasteful clothing. The *1ily" work on Solo- 
mon's Temple was but the symbol of the "lily" work in all 
that the Creator has made. More "lily" work in the life 
of all, whether poor or wealthy, means a nearer approach 
to the ideal life. 

Strictly speaking our mental work commences with the 
thought "that all outward expression of mental states and 
mental action is by visible movements and results of move- 
ments." Working upon this hypothesis, we first train our 
children in physical and manual work. In application of 
the thought "that stimulation is necessary to movement as 
well as supply of blood to the nerve centres," we have a 
regular system of brain training, commencing in the morn- 
ing with singing lessons in which we use the Cheve sight 

26 



method, appealing alike to sight and sound, the common 
stimuli. Afterwards gymnasium, articulation, and kinder- 
garten classes, based upon scientific principles, arouse and 
stimulate latent mentality. 

In the gymnasium we do solid, earnest work with the 
thought "that a muscle duly suppHed with good blood, if 
stimulated to action will grow; the nerve centres of the 
brain which stimulate the muscles are affected at the same 
time and tend to act on future occasions with more exact- 
ness and more quickly when stimulated by the same word 
of command." Our object is to drill the nerve centres or 
different portions of the brain, increasing thereby the quick- 
ness and precision of their action; therefore we leave the 
brain as far as possible to command, and avoid drills with 
dumb-bells, wands, and Indian clubs, preferring to gain 
attention and perfect time of movement rather than strong 
muscular action. For entertainment and amusement, how- 
ever, we have drills. Merely mechanical work is avoided 
in the daily exercise of different groups of muscles. The 
system which best secures these results is the Swedish. 
After a careful study of the different systems of physical 
culture and the use of some for various purposes, we find 
that for good gymnastic work and stimulation of the brain 
cells, nothing equals the Swedish, both passive and active. 
Aside from the half-hour in the gymnasium given to each 
class, individual practice is provided for special physical 
trouble. Dancing, thoroughly taught, is also an important 
, feature of our work. 

After the work in the gymnasium the children change 
from class to class for articulation and special nature work, 
in winter drawing lessons from plants in the greenhouse, 
and in summer in the woods and gardens. Living objects, 
birds, chickens, rabbits, horses, ponies, and donkeys furnish 
topics for lessons, and for indoor work a number of good 
class objects are provided. In the advanced class not only 
are talks given but drawings are made by the children and 

27 



the lessons take the form of a written exercise. In every 
lesson we endeavor to draw from the children the brain 
thought, or at any rate by means of pictures to create a 
mental image. Objects, plays, and other means are resorted 
to until it seems that the mental impression is made. Ap- 
plying this method to articulation we have found it suc- 
cessful when no other seemed to avail. 

Reading and number work are all based on objects; but 
in every case the object lesson is not left until a thorough 
knowledge is acquired and the child knows how to apply the 
lesson. Each class is given a daily lesson in sight work 
on numbers and words placed on the board and erased. 

In articulation we combine the Pollard and Ward sys- 
tems, but frequently use methods of our own suggested by 
experience. 

The teachers are required to report any signs of ner- 
vous exhaustion during the daily lessons. And when it is 
indicated by naughtiness or irritability, the child is told that 
he or she is not well and is sent away for an hour's quiet 
rest, or for a walk or ride in the fresh air. We always try 
to avoid the word bad, and as a rule we have no naughty 
children. We have children whose hands are restless and 
whose feet are too tired to walk just right, and sometimes 
children whose tongues are very sick and say naughty 
words. But rest or change of work is needed to correct 
these conditions. In the case of older children who have 
not had such training, great care is required, but with little 
children we find this method works like a charm. 

Of manual work I think I may say we have the best 
system of the kind in the country. It includes work in 
wood and clay, wood-carving, free-hand drawing, painting, 
and Indian basket work, and, of course, daily lessons in 
sewing. Our wood work is a combination of the Russian 
and Swedish system of Sloyd. The youngest child is 
taught to handle tools, and as soon as a straight line can 
be made by saw and carving tool, the child makes his first 

28 



object, a key-rack, calendar holder, thermometer or blotter. 
In clay work the same method is adopted until the child 
is sufficiently trained to model from nature. In painting 
and free-hand drawing the same course is pursued. The 
same leaf which is copied in wood-carving serves as a 
model for clay work and is drawn and painted. The Indian 
basket work too is helpful in developing the fine touch re- 
quired for selecting, weaving and bending the splints. Of 
the advanced class a knowledge of the different kinds of 
woods, their various names and their uses, is required. 

The outcome of this kind of training can hardly be 
estimated or described. Take a single instance. A little 
girl, entered in September almost three years ago, had no 
command of figures, was restless, lacking all power of at- 
tention and concentration, and was in many ways very 
deficient. It was almost four months before her fingers 
could trace a 2 from dot to dot. To teach her to handle 
pencil or chalk seemed a hopeless task. To-day she can 
write one hundred words from dictation, or any number 
from I to 50, can read fairly well, and in all other work 
has improved in proportion. A boy who has been with us 
less than two years, who knew nothing when he came, has 
made still more rapid improvement in the gymnasium and 
also in manual work. 

The causes, characteristics and treatment, general and 
particular, of mental deficiency, have thus been set in due 
array. But our task would be incomplete, the time ill spent, 
were it not possible to bring out some central thought, to 
find some salient point on which, as on a peg, the whole 
argument may hang. The causes we are unable to eradi- 
cate. The characteristics though varied are familiar. It 
is in the method of treatment that the main interest must 
lie. And here the first word and the last, the secret of 
everything, is thoroughness. If, as we know, slipshod in- 
struction and study are deleterious to the normal pupil, 
how much more to the mentally deficient! Accuracy in 

29 



the minutest detail, logical processes of thought, a faithful 
conscientiousness far removed from any perfunctory in- 
struction, are essentials without which the work would be 
better undone. No class of pupils requires so much the 
sincere, earnest teacher as these children. Such an instruc- 
tor will ever bear in mind the words of the greatest Teacher : 
"For inasmuch as ye have done it unto the least of these, 
ye have done it unto Me." 



30 



Ill 

HINTS ON THE CARE and TRAINING 

OF MENTALLY and MORALLY 

DEFICIENT CHILDREN * 



IN these closing years of this great century of humanita- 
rian schemes and projects, an ever increasing interest 
is manifest in the "what to do" and the "how to do it" 
for those who are mentally, morally or physically deficient, 
and even the mite that I shall add to the general collection 
may assist in helping on a hitherto much neglected but a 
transcendently noble and important work — the training of 
weaker humanity. It is our hope that a few facts impres- 
sively presented from time to time may spur on these think- 
ing men and women of the National Educational Associa- 
tion to lend their powerful aid to the great task of devel- 
oping a system of training that shall meet the peculiar 
needs of a class of children whose clouded minds and joy- 
less lives should appeal strongly to all on whom Providence 
has bestowed well-balanced mental faculties. 

Before entering upon the details of the training best 
suited to the mentally deficient, two important points may 
be considered, viz., the size and character of the state 
schools which should be established; and the desirability of 
abandoning the use of the terms, "idiot" and "imbecile," 
and the substitution of words which will not imply a slight- 
ing disrespect. 

* Read at the Meeting of the National Educational Association, Washing- 
ton, D. C, July, 1898, at the time of the first discussion of Mentally Deficient 
Children by the Department of Special I^ducation of the Association. See 
Proceedings of N. E- A., 1898, p. 1040. 

31 



The number of pupils and the subjects and methods of 
instruction in such schools are vitally important questions. 
"Science," says one of our great thinkers, "is organized 
common sense." Can any intelligent human being believe 
that there is "organized common sense" in bringing together 
under the roof of a single institution, hundreds of human 
beings afflicted physically to a degree that causes mental 
deficiency? Think of it, you who are students of physi- 
ology, and predict the results! Think of it, you who are 
students of psychology, and calculate the loss of mentality 
to those who if surrounded by the proper environment 
might gradually approach toward a normal development. 
Think of it, you who are earnest students of biology, is 
this the way you would treat a pet specimen which you 
wish to preserve, and of which you desire to note the 
growth ? 

The thoughtful mind cannot fail to see that little is as 
yet generally known of what may be done for mentally 
deficient children. Requiring, as they do, more tact, more 
personal care and more scientific teaching than either the 
deaf or the blind, they yet receive less than any other class 
of defectives, and we appeal to-day for justice and for that 
alone. 

In 1850, in the United States, the mentally deficient 
numbered 9,830; in 1890 the number was 97,097; and it is 
probable that in the last eight years the number has in- 
creased more rapidly. Dr. Fernald estimates one mentally 
deficient person for every 500 people in the United States. 
In the present year (1898) there were twenty-four state 
schools with 8,492 inmates. Think of this and compare 
with it the number of institutions for the blind and deaf. 
Is it anything like a pro rata provision? Since writing 
the paper which was read in Washington in May last, there 
have come to our notice two very touching appeals on be- 
half of children who, it appears, cannot be admitted to any 
state institution. 

32 



In one case the boy has been refused several times on 
the plea of lack of room; yet in that very institution any 
one who is willing to pay a good sum annually can secure 
admission for a child. Should there not be a state law for- 
bidding any admission to the state institutions excepting 
where it is proved under oath that the parents are unable to 
defray expenses? Such a measure would discourage need- 
less pauperism and thus reserve the state schools for those 
who have real need of them — those who are unable to have 
suitable care at home. It is not our idea to exclude pay 
patients from the state schools, but there certainly should 
be no discrimination against those who cannot afford to pay 
for care. Rather should these be admitted in preference to 
those who are able to provide private tuition. 

Schools should be estabHshed throughout the different 
states, with a capacity for a number not exceeding one 
hundred, and should be arranged on the cottage plan; each 
cottage having a family of twenty-five, graded according to 
the mental status. There should be placed in each family 
of higher grade two pupils of lower grade, so that those of 
lower grade may get the mental benefit of contact with those 
of the higher class. This would also give the matron the 
opportunity of seeing what help and care are required by 
those of the lower grade. The assembling together of a low 
grade is very detrimental, as many of these children, per- 
haps from some physical disfigurement, appear more defi- 
cient than they really are, and these can be profitably placed 
under observation with a higher class. 

This increase in the number of schools at first appears 
to involve very large expenditure ; but if the perquisites and 
other minor items which go more or less with large appro- 
priations, were deducted, and if the work were taken out of 
the hands of politicians, the state would not be at a much 
greater expense than is necessary for one large institution ; 
and the advantage which would accrue from the practical 
and scientific management of this class, which to-day is 

33 



increasing so rapidly, would fully compensate for any 
additional outlay. In each of these small state homes 
there should be a school-house equipped as thoroughly as 
for normal children. All appliances needed for object teach- 
ing should be at hand. Physical culture and manual work 
departments should be fitted with the best apparatus and 
tools. There should be not less than six good teachers for 
this number, each thoroughly qualified in her special branch. 
Nature work should be well taught; and for the older class 
a laboratory is advantageous. In other words, the work 
should be conducted with the same thoroughness as if it 
were expected that some day these children might be fitted 
to enter college. 

With this kind of instruction, maintained by able 
teachers under these favorable conditions, the coming cen- 
tury would witness a marvelous improvement mentally in 
this class of unfortunates. 

The physical care of the pupils should be given to 
none but first-class practitioners. No resident physician can 
acquire sufficient experience to do all that can be done for 
the mentally deficient or insane. No one but a physician 
from the outside, coming in daily contact with different 
diseases in the clinics of the hospitals, can be qualified to 
care for these who are afflicted in a thousand different ways. 
Such a physician would bring new thought, new impetus 
and new interests, which would result in maintaining the 
best possible medical and surgical health standard in 
the school. 

Physicians of any reputable system should be per- 
mitted to treat such cases, since conditions which practi- 
tioners of one school might fail to benefit might be success- 
fully met by another. With earnest hand-to-hand work, 
physicians of the several schools of medicine in each state 
institution would be equal to all emergencies, as each physi- 
cian would see that his special charges were properly man- 
aged both in regard to training and physical care. Much 

34 



in the way of careless nursing and management would be 
remedied if this plan were carried out. 

It would be well also for this Association to urge the 
passage of a state law providing that every mentally defi- 
cient boy (whose mental deficiency is positively certified by 
three competent physicians) be castrated before the age of 
puberty. Such a procedure, regulated by law, would be a 
humane measure to prevent the perpetuation of mental 
deficiency, and it would also be a great advantage to the boy 
himself, who has not sufficient intelligence to control that 
which is or may become a pernicious and dangerous habit. 

The training of all children, especially those whose 
mentality is deficient, should be based upon the scientific 
dictum that all "outward expression of mental states and 
mental actions is by visible movements and results of move- 
ments." Working upon this basic principle, the children 
should be trained in physical and mental work, thus utiliz- 
ing the physiological fact that systematic stimulation is as 
necessary for development as is a supply of food for the 
healthy functional operation of the nerve centres. Sight 
and sound are the more common stimuli to movement, and 
a methodical brain training founded upon this principle, and 
accompanied by the appropriate exercises, in rotation, of 
all of the brain cells responding to the senses, will produce 
good results. The extent of the improvement will depend 
of course not only upon the excellence of the teaching but 
also upon the degree of deficiency, the cause and the struc- 
tural defect in the individual case. 

In conducting physical culture, the work should be 
done on the principle that a muscle duly supplied with good 
blood, if stimulated to action, will grow. The nerve centres 
which stimulate the muscles are affected at the same time, 
and tend, on future occasions, to act with more exactness 
and promptitude when stimulated by the same word of 
command. The object should be to drill different portions 
of the brain, increasing thereby the quickness and precision 

35 



of action. To increase brain development we work on these 
general lines ; but for simple amusement we may intersperse 
drills with music, and make use of Indian clubs, dumb-bells, 
etc. Such drills are not intended for brain development. 
Each day the different groups of muscles should be exer- 
cised. The so-called Swedish system is best suited for this 
purpose. Other systems are also good, and parts of these 
may be incorporated into a general system by intelligent 
instructors. In other words, a thorough teacher in the 
physical training of the backward child should be well 
versed in all of the practical systems, and should be com- 
petent to adapt them to the individual demands of her 
charges. The ball and many German games are very help- 
ful in the training of the senses. For children with back- 
ward or peculiar gait the Emerson system is beneficial. 
Some children are unable to do any active work, and for a 
time will require passive movements, with perhaps some 
special apparatus adapted to their particular physical needs. 
The results in correcting curvature and badly shaped limbs 
have, in our experience, been most marked in using the 
passive Swedish work. 

To obtain the best results almost everything depends 
on the selection of teachers with strong and adaptive indi- 
viduality, who are able and sufficiently interested to become 
for the time the mind, so to speak, of the pupils under 
their tuition, thus stimulating mentality by a sort of mag- 
netic influence. Girls possessing this natural gift, with a 
good common school education, make the best teachers. It 
should also be remembered that this work incurs a mental 
strain far greater than in ordinary teaching, and the con- 
tinual "giving out" exhausts the mind, unless the teacher 
daily engages in different occupations to restore her equi- 
librium. At the teachers' meetings, this should be well 
impressed on the instructors, so that they may know of 
this condition and understand the necessity for regular 
mental change. If this course is pursued the teacher will 

36 



not break down, but on the contrary will become brighter 
and more efficient each year. As the work demands so 
much in the way of mental resource, a successful teacher 
is compelled to ''grow into" it in a manner not required in 
the training of normal children. Strong, thoughtful studies 
are those which should be pursued by those desiring to 
obtain the maximum of success as instructors of these 
children. 

The second important matter in connection with this 
class of children is the absolute and universal abandonment 
of names which are neither accurate nor dignified — the 
terms idiot or imbecile. When these obnoxious words are 
banished we may expect that more interest will be mani- 
fested, both by the laity and by those who have the pro- 
fessional care of this class. Dr. Ireland tells us that the 
terms are not descriptive, and furthermore that it is diffi- 
cult to frame a terminology comprehensive enough to in- 
clude all the meanings in which they have been used. We 
agree with Dr. Ireland, and feel that until less objection- 
able terms can be found to apply in such cases, the phrase 
"mental deficiency" is not only free from the stigma of 
reproach, but is properly descriptive of the condition. This 
Association is doing and has done much to broaden all 
mental work, and it is my earnest desire that you will in 
the future insist on this change of name in justice to these 
children who cannot speak for themselves. If this can be 
accomplished you will do a very great kindness to these least 
of God's little ones. 

There has been a request that I present some thought 
on the matter of those more nearly normal children who are 
yet unable to cope with the normal child, on account of 
some physical disability; and that I offer also some sug- 
gestions on the management of the morally deficient. It 
is difficult to convince the Board of Education that these 
children who can not keep pace with those who are normal, 
should be provided with special classes or schools. These 

Z7 



are urgently needed because the consciousness of being less 
apt than their brighter classmates naturally impedes, in 
this weaker class, the development of the intellect, which 
under more favorable circumstances might grow rapidly. 
The schools for these children should be entirely separate, 
but every care should be exercised so as not to make the 
children attending them feel any consciousness of inferiority. 
This will be a most delicate difficulty to overcome. Chil- 
dren are so prone to make remarks (hearing as they do 
matters discussed by their parents) and the little ones at- 
tending special schools will be made to feel their backward- 
ness, unless each Board and each teacher shall control the 
matter in a very judicious way. It is impossible suitably 
to place these children in a separate class in the same school 
with pupils possessed of the normal capacity for learning. 
They can be cared for to best advantage only in separate 
schools, which schools must not by any implication be con- 
spicuous as schools for dull children ; but on the contrary 
they must be made schools with such environment that the 
children may feel every incentive to advance. 

It is not necessary to speak here of the great need of 
proper and thorough medical examination in our schools. 
Miss Keen's paper on that subject in May, was so thor- 
ough and comprehensive that it fully covered this most im- 
portant subject. Every one engaged in educational work 
knows the necessity for good medical direction, and knows 
also how much trouble, as well as expense, can be saved 
to the public if all children who are physically disabled be 
placed in time under proper medical treatment. 

These schools should provide physical and manual 
training, and the mental work should go harmoniously 
hand in hand with these two branches. The fear at pres- 
ent with those who are giving this matter thoughtful atten- 
tion, is the encroachment of the manual work and physical 
training on the mental. This would indeed be a grave 
error, but one that can be easily avoided. These schools 

38 



require the best teachers, those able to note the effect, 
psychical as well as physical, of the different kinds of work ; 
whether, for instance, certain movements in the physical 
training induce or stimulate certain mental results; and 
also the mental effect of certain kinds of manual work. 
The ideal teachers for this work must possess native, inborn 
tact, as well as a good working knowledge of psychology 
and physiology. No second-rate teacher should ever be 
placed in charge of such children. You, as an Association, 
must strenuously insist on this. You have already done 
much good work, and now Philadelphia and other large 
cities require your further influence in this line. 

The next problem has been thus far unsolved. What 
is the best training for the morally deficient? Speaking 
from experience we are of the opinion that the ordinary 
school is not the place for these children. A little training 
is worse than none. Give a baby sharp tools, without any 
knowledge of these tools excepting the fact that he can do 
certain things with them, and the result is disastrous. 
Give morally deficient children a little general knowledge, 
and you have simply handed them the tools to do far greater 
mischief than would be possible if they had remained in 
utter ignorance. 

The places for training the morally deficient must be 
small home schools, where the children can remain under 
the most judicious training from earliest childhood until 
past twenty-one. The studies must be of the best kind, 
developing the mind of the pupil so thoroughly that these 
immoral tendencies would be brought under control. I 
know of a case in point, that of a child who was unques- 
tionably deficient morally. She told falsehoods, she stole, 
and in many other ways showed the most cunning and 
treacherous tendencies. The child had an abnormally bright 
mind, and in the course of years she was thoroughly trained, 
receiving a college education. In her case, although these 
evil tendencies are still occasionally manifest, the woman, 

39 



by this exceptional training, has been made aware of the 
necessity for keeping constant guard against temptation. 
Her cultivated intellect has given her control over these 
strong evil tendencies. This is the one way in which such 
children can be reached. But how get the public to realize 
this? Houses of refuge, and other so-called reforma- 
tories, are not the proper places for such children. 

Suitable homes, then, should be under the care of 
expert psychologists, and the best physicians should be in 
daily attendance to note the individual results and decide 
as to whether there should be separation of those more 
deficient than others. 

If certain children cannot be reached in this way, then 
they must be placed in permanent homes ; they are no more 
fit to be at large than are the incurable mentally deficient 
or the insane. The morally deficient child or adult holds 
sufficient influence to do a great deal more harm than the 
insane or mentally deficient. All know what they must 
expect from the latter, but the moral lack is so completely 
hidden beneath an apparently correct exterior that people 
are deceived in nearly every instance, and incalculable evil 
results because of the absence of restraint on the conduct 
and action of these moral weaklings. 

The increase in moral deficiency is about pro rata with 
that in mental deficiency, and this is because the public, in 
its general lack of interest, has felt that no special pro- 
vision need be made for this class. The reverse is the case, 
and the ultimate satisfactory solution will be reached, step 
by step, only by patient, earnest, thorough work, based upon 
the surest foundation of truth. The best must be given in 
school work and pretty homes. This, to many, sounds 
absurd, but when you count the expense these people are 
to the State afterwards, the ounce of prevention will evi- 
dently be better than the pound of cure. It will be well to 
reflect for a moment on the cost to the State of each theft 
committed, each murder perpetrated. 

40 



In conclusion, permit me to say that in settling this i 

difficult problem there should be no hesitation about unsex- \ 

ing both the male and the female where it has been proved | 

beyond doubt that the moral deficiency is beyond help, ex- i 

cepting that the sufferer is to be made comfortable, as in i 

the case of the incurably insane or the mentally deficient. I 

If we meet the question wisely and heroically, with organ- ' 

ized common sense, it will not be long before a practical I 
solution of the moral question will be reached. 



4i ] 

I 



IV 

THE 
CLAIMS OF THE FEEBLE-MINDED* 



THE memorable events of the passing week, the 
crowded sessions, the learned papers and discussions, 
all these have shown rapid strides in educational pur- 
pose and technique; and, as applied to the vast army of 
normal children, would seemingly show that the race is 
always to the swift and the victory to the strong. But in 
the quiet of this gathering at the fag-end of this great 
convention we surely must not lose sight of the paramount 
claims on our attention and sympathy of the less richly 
endowed little ones who in this age of progress toward 
perfection have too often received but little share of the 
advantages so freely ^ accorded to their more fortunate 
brothers and sisters. 

The first step in satisfying the claims of mentally defi- 
cient children is to see that training schools are established 
in every state, and day schools, with facilities for the spe- 
cial training of backward children, in every city. Some 
may ask: "Cannot these children be trained in their own 
homes or with other children?" I answer, "No;" for the 
conditions in which such boys and girls are placed are such 
as to make suitable training an impossibility. In dealing 
with such children every cause and effect should be care- 
fully studied by the skilled practitioner and the student in 
psychic phenomena, in order to remove, if possible, the 

* Abstract of the Vice-Presidential Address, read at the meeting of the 
National Educational Association, Charleston, S. C, July 13th, 1900. See Pro- 
ceedings of the N. E^. A., 1900, p. 674. 

42 



bodily obstruction, whatever it may be, which impairs or 
prevents the normal working of the mind. 

Backward and mentally deficient children need spe- 
cially trained teachers, and also a human environment 
adapted to their peculiar needs. They must be under the 
care and influence of those who can comprehend with sym- 
pathetic intelligence their peculiar phases of mind — phases 
at once complicated, delicate, and sensitive in the extreme. 
Therefore to place them in the care of teachers not specially 
trained, or in classes with normal children, is a procedure 
as unintelligent as it is unkind. We must surround them 
with the persons, the objects, and the scenery which will 
develop their limited powers as fully as such favorable con- 
ditions alone can make possible. This can be done only by 
providing state and private schools in which the selection 
of teachers, of methods, and of appliances shall be made 
with intelligent reference to the special needs of such 
children. 

Let me say one word in regard to the proper teachers 
for these children. Knowledge of psychology gives an 
insight into the work which will be highly beneficial, and we 
do not speak disparagingly of it; but given two teachers, 
otherwise well qualified, that one will be the more successful 
who is possessed of a motherly instinct and a sympathetic 
nature. Should you add to essential characteristics a suit- 
able practical training and a working knowledge of psy- 
chology, you have the perfect teacher for mentally deficient 
children. Take away the sympathetic nature and the 
mother-love, and substitute merely the cool, calculating, 
scientifically trained teacher, and place such a teacher over 
these children, and you will have no satisfactory results. 
We want common-sense brought to bear in this matter. 
Therefore I would urge the establishment of training classes 
for teachers for mentally deficient children. These classes 
should be attached to good schools for such children, where 
teachers in training would get a practical knowledge by 

43 



daily experience. In this way efficiency would be secured, 
the teacher getting at the same time a practical and a 
psychological training. 

In view of these considerations may I be permitted to 
urge that a representative from our work be placed upon 
your committee, which at present represents secondary 
schools and high schools, but which has at present no mem- 
bers representing the interests of the blind, the deaf, or the 
mentally deficient? We need the mentality which may 
accrue from this union, and you need the practical knowl- 
edge which we shall be able to bring to your meetings. 
There is every reason to feel that such a representation 
would result in benefit to all concerned. We urge the 
appointment of a delegate from schools for mentally defi- 
cient children and one representing the interests of back- 
ward children ; and that the papers and discussions in these 
meetings be reported and printed in our magazine; thus 
giving to the teachers in our institutions the benefit of 
your advanced knowledge. 

I desire to call attention to the needs of the southern 
states and to express the hope that this Association will use 
its influence to secure the establishment of state schools 
of this kind in the South. We have on an average one 
mentally deficient child to every five hundred in the popu- 
lation, and practically no provision in the South for their 
training. I also call the attention of the public to our pri- 
vate schools for neurotic children. I see no reason why 
these schools, which are doing good work in this line, 
should not receive endowments as do our colleges and 
universities. 

In the well-conducted private school where individual 
work is done in the class a better knowledge can be ob- 
tained as to real results than in any other way. If these 
private schools should receive from time to time small 
endowments, they would be enabled to pursue a course of 
scientific work which would be impossible in our larger 

44 



institutions. One of these schools, with an average attend- 
ance of less than twenty-five children, spends annually, in 
caring for and training them, $23,000. With such an ex- 
pense as this you can readily see that the school could not 
afford the additional cost of extra scientific experiments. 
I have no doubt that other private schools could send a 
similar report, and that they all desire to invite inquiry and 
inspection. For my own part I would urge that the private 
schools should be open to state inspection. 

Like Cato, who always finished every speech with the 
words, "Carthage must be destroyed," I shall always, in 
pleading for the mentally deficient child, strongly urge that 
such children be unsexed. For this there are two reasons : 
first, that there should be no possibility for such children 
to propagate their kind ; secondly, for humane reasons. This 
idea, given out two years ago, received thoughtful con- 
sideration and resulted in good. I hope that the next two 
years will see some state, if not states, sufficiently advanced 
in civilization and humanity to pass a law requiring the 
unsexing of all those unfitted to propagate their kind. This 
law should apply to all cases of pronounced mental, physi- 
cal, and moral deficiency. In this way the action of the 
state will radically remove a great part of the underlying 
cause of degeneracy. 

For the same end, the thoughtful and highly enlight- 
ened members of this great educational Association, as they 
return to their respective fields of labor, must use their 
influence in making the teachers in our schools see to it that 
students under their care, from kindergarten to college, 
should be taught the laws governing physical and moral 
development, so clearly, so positively, that each boy and 
girl, as body and mind advance to maturity, may see it to 
be their sacred obligation to prepare themselves to perpet- 
uate physical and mental soundness. This will do away 
with impurity of thought and action. 

Since I last spoke before this Association I have been 

45 



more than gratified to find that the terms "idiot" and 
"imbecile" are gradually being dropped; "mentally defi- 
cient" and "backward" are the words substituted. Chi- 
cago employs the term "neurotic," which, thus far, is the 
best name for the class of children in which we are inter- 
ested. In the work we are called to do as educators we find 
that all our pupils, even those regarded as normal, are more 
or less deficient in some mental or physical feature or 
endowment ; and I wish that, as applied to the class of pupils 
in which our department of the Association is especially 
interested, the term "defective" might be dropped. Un- 
less you make a division which will place all who are not 
absolutely perfect, physically, mentally, and morally, on 
the "defective" list, you have no right to make any divi- 
sion. We therefore respectfully request that, in the future, 
this department be known as the department for the blind, 
the deaf, and the neurotic. 

The new theory of evolution puts forth the idea that 
the fittest are responsible for the rest. Shall not we, who, 
we trust, are fittest, feel our sacred responsibility in having 
entrusted to our care these weaker little ones who have 
come into this great world imperfectly fitted to carry life's 
heavy burden? The normal child can, to a great extent, 
manage his own education ; and yet it would seem that 
almost all our educational thinking looks to the care and 
developing of the mentally sound and capable. While rec- 
ognizing the importance and the wisdom of giving our best 
efforts in good measure to the training of the large body of 
our youth who are mentally strong, I would most earnestly 
solicit for the less fortunate a measure of thought and effort 
commensurate with their urgent needs. 



46 



V 

CLASSIFICATION 
OF THE MENTALLY DEFICIENT* 



IT is related of Pythagoras by Cicero, that once upon a 
time Pythagoras came to Philius, a city of Peloponnesus, 
and while there he displayed in a conversation which he 
had with Leon, who then governed that city, a range of 
knowledge so extensive that the prince, admiring his elo- 
quence and, ability, inquired to what art he had principally 
devoted himself. Pythagoras answered that he professed 
no art, and was simply a philosopher. Leon, struck by the 
name, again inquired who were the philosophers, and in 
what they differed from other men. Pythagoras replied 
that human life seemed to resemble the great fair, held on 
occasion of those solemn games which all Greece met to 
celebrate. For some, exercised in athletic contests, resorted 
hither in quest of glory and the crown of victory; while a 
greater number, attracted by the love of gain, flocked 
thither in order to buy and sell. There were a few, how- 
ever — and they were distinguished by their liberality and 
intelligence — who came from no motive of glory or gain, 
but simply to look about them, and to take note of what 
was done and in what manner. "So likewise," continued 
Pythagoras, *'we men all make our entrance into this life 
on our departure from another. Some are here occupied in 
the pursuit of honors, others in the search of riches ; a few, 
who are indifferent to all else, are they whom I call students 
of wisdom, for such is the meaning of 'philosopher'." 

* Read at the National Conference of Charities and Correction, Washing- 
ton, May 14th, 1901. See Proceedings of the N. C. C. and C, 1901, p. 19^' 

47 



This anecdote seems peculiarly appropriate to this 
body of workers, men and women interested in the highest 
development of the race. With this end in view it is neces- 
sary that you inform yourselves on the absolute and rela- 
tive utility of all branches of knowledge in order to apply 
where needed that which will bring the best results to man- 
kind. No doubt great discouragements meet you each 
year and problems face you which seem appalling; but we 
always find that the sciences which are studied with the 
keenest interest are those which are in a state of uncertainty 
and unfolding. Finished certainty and absolute comple- 
tion would be the paralysis of any study. What is true of 
science is true indeed of all human activity. 

In life, as the great Pascal observes, we always believe 
that we are seeking repose, while in reality all that we seek 
is agitation. Under the same conviction Plato defines man 
as **the hunter of truth." 

"Our hopes, like towering falcons, aim 

At objects on an airy height, 
But all the pleasure of the game 
Is afar off to view the flight." 

*'The intellect," says Aristotle, ''is perfected not by 
knowledge but by activity." The arts and sciences are 
powers, but every power exists only for the sake of action. 
You are obtaining a knowledge of human powers and 
human progress by your activity, your earnestness to meet 
and overcome the evils of life. 

The talk assigned to me would perforce compel me 
to delve deeply into the mind in its normal and abnormal 
windings. We use the term mind^ when we really mean 
physical conditions which favor defect or annul certain 
mental conditions. We cannot rationally define the abnor- 
mal until we are quite famihar with the normal, and deduce 
from this standard the conditions which produce the ab- 
normal. 

I cannot better express the meaning of normal than 

48 



by quoting the scholarly definition of Dr. W. R. Newbold. 
''Normal properly means conformable to type, or con- 
formable to the standard. The type is properly determined 
by the average of instances, and has no direct reference 
to the end subserved. We may thus regard a given scrap 
of stone, or a case of typhoid fever, as normal, i. e., as 
types of their kind, without any covert teleological refer- 
ence. But, when in any given class conduciveness to a 
given end is a relatively constant feature, it necessarily 
becomes imbedded in the type concept, and the latter be- 
comes teleological. When the end subserved is generally 
advantageous, a tendency manifests itself to enforce upon 
individuals conformity to the type ; and the latter thus as- 
sumes, to the consciousness of the community, the form of 
a standard to which one ought to conform. Supernormal 
and subnormal denote the notion of degree, which is not 
found in abnormal, pathological or morbid. A man may 
be supernormal either by possessing all the normal facul- 
ties in extraordinary degree, or by possessing new facul- 
ties not found in the normal man. Thus this word has 
chief reference to normal in its first sense of average or 
ordinary. But if the new faculties or the unusual develop- 
ment of normal faculties were distinctly injurious to their 
possessor or to the race we would scarcely term them super- 
normal. Thus the word, like normal, denotes two mean- 
ings, above the average, and more in conformity with the 
ideal. So, of subnormal, the primary meaning is below 
the average, but it also refers to the ideal as a standard; 
e. g., we would scarcely designate a child who is notably 
deficient in temper as subnormal or as abnormal unless that 
deficiency amounted to a defect, /. e., tended to the child's 
detriment." 

The types of deficiency of which I am to speak stand 
not merely for shortcomings as compared with the average 
child, but for defects as compared with the standard ; and 
by standard in this case we mean that particular combination 

49 



of physical and mental powers which will best conduce 
to happiness and length of life under the conditions 
actually known to us. 

It is as difficult to classify the variations of the abnor- 
mal mind as it is to differentiate the extravagancies of the 
normal. We can only generalize roughly. To classify we 
must arrange according to resemblances and differences (or 
variations). Every class should be so constituted as to 
contain objects exactly resembling each other in certain 
definite qualities which are stated in the definition of the 
class. This we cannot really do with the abnormal, for the 
differences, even in the individual cases we place under 
the same general head, are often marked. In our endeavor 
to make a systematic arrangement we feel like the cele- 
brated Turgot, who said, "the first thing is to invent a sys- 
tem and the second thing is to be disgusted with it." In 
trying to differentiate the various types of mental deficiency 
and marshal them in order, I have been discouraged by the 
difficulties in the way, and very much dissatisfied with the 
attempts which have been made from time to time and 
which have become classic in the medical text books. In 
order to render a clear non-technical idea of the abnormal 
classes as they have come under our observation, I shall 
present to you the views of a layman and not the technical 
subdivisions of the medical specialist. 

In our work, we have first, those that are backward by 
reason of some sensory or motor deficiency; second, the 
mentally weak; third, the mentally deficient; fourth, the 
morally weak, and as an aggravated form of the same, the 
morally deficient. 

In the first division we include all who by reason of 
some sensory defect are unable to compete with the so- 
called normal child. In them there is almost invariably a 
physical defect apparent to the physician or teacher, the 
deaf, blind, partially de^f-^'^^a^rtially^^^ ^W also those 

who are backward on a^^^t oi sorne^lack of motor control 




which is recognizable by the eye. For this class of children 
(and they are more numerous than ordinarily imagined) 
we need special schools and special training, in connection 
with the public school system, and where this is given, in 
many instances, we find the children after the first few 
years of this individual training (which should include 
physical and manual work with the mental), frequently 
able to take their place with normal children. Many after 
a time develop into bright men and women. A large per- 
centage of our criminal classes to-day were among the 
backward children of a generation or two ago, and because 
the educational facilities were not of the kind to develop 
the best in them, these children drifted into being truants 
and afterwards swelled the number of inmates in houses of 
correction, criminal courts, etc. We need to-day, in every 
state and every city, special schools for these backward 
children that they may not so drift into crime. Our insti- 
tutions should not have such children. As far as possible 
we should have day schools and small homes with not over 
twenty children in each home, the children daily attending 
public schools. This provision would include a number 
of other children who are now boarded out by children's 
aid societies. These children, who require the most deli- 
cate insight and most careful watchfulness, are more fre- 
quently boarded in families where the mother has not even 
an intelligent idea of bringing up her own offspring. There 
is a false sentimentality about this matter. Children who 
come into the world handicapped with sensory or motor 
defects or marked with the stigma of illegitimacy need 
above all others the environment and intellectual surround- 
ings of cultured women. This could be done by the state's 
providing small homes and placing at the head of such 
homes ladies capable of acting as house mothers. We have 
many women eminently fitted to fill such positions. With 
this environment, and public schools specially adapted to 
the training of backward children, there would soon be a 

51 



wonderful advance in the acquiring of true wisdom by the 
youthful population now swarming our large cities. In 
any case, where a child is so physically incapacitated as to 
be unfitted to propagate his or her kind, such a child should 
be unsexed in order to preserve the purity and healthy con- 
dition of humanity. This serves the two-fold purpose of 
preventing the lowering of the race and also of preserving 
such a child from untold suffering in the future. 

Under the next division, the mentally weak, we have 
a more complicated state of affairs. Here the defect is not 
visible to the unskilled eye. The child seemingly has all 
senses developed, can walk, talk, etc., yet all his faculties 
are in such an undeveloped state as to retard the growth of 
the mind. This may be due to the lack of development of 
the cells of the brain or the partial destruction (by disease 
or accident) of the nerve fibres, the projection fibres, or to 
lack of co-ordination, or to disease or general weakness of 
the nerve tracts of the cerebro-spinal axis. 

These children need the care and training of good 
schools, and should as early as possible be separated from 
normal children ; for the normal children only retard their 
advancement. The skilled neurologist, who has made a 
, special study of such cases, should be consulted, rather than 
the family physician. The trained eye of the specialist 
will more readily note the defect and more rationally direct 
the remedy; for this is his work, a work which requires 
the most painstaking study. The child needs physical care, 
and medical gymnastics; teaching him, one should begin 
with whatever engages his interest rather than with the 
topics which logically introduce the subject. He needs also 
the watchful eye of those accustomed to note the physical 
weakness, as he needs change of occupation at times. Such 
children will frequently develop to an advanced stage ; in 
fact, I have yet to see a mentally weak child who has en- 
tirely ceased to develop. We have with us a girl who is 
almost forty, and to-day she readily takes up new work 

52 



and will persevere until she has accomplished what she has 
started out to do. We have been able in our individual 
work to refute the theory that after a certain time the mind 
of the mentally weak ceases to grow. So far, in our seven- 
teen years of experience, we have yet to find any child 
remaining at a given point or going backward. Of course 
they have every possible care, and therefore a judgment 
to the contrary, based upon experience in large institutions 
where it is impossible to give this careful, watchful atten- 
tion, is fallacious. We may find such cases, but as yet they 
have not come to our notice. 

Passing from the mentally weak, we come to the men- 
tally deficient. With these we find the way dark and the 
work discouraging at first ; but frequently that which seems 
a mere bundle of flesh and bones will, with loving care and 
beautiful environment, awaken to a degree of intelligence 
which is astonishing. 

Dr. Ireland has suggested a classification of the men- 
tally deficient which seems to me the best I have seen. His 
division is as follows : Genetous, microcephalic, hydro- 
cephalic, eclampsic, epileptic, paralytic, traumatic, inflam- 
matory, sclerotic, syphilitic, cretinic. I will briefly refer 
to some of the characteristics. 

In genetous deficiency the diseased condition is com- 
plete before birth and the presumption of heredity is 
stronger than in other forms. Very frequently the youngest 
child of a large family is found deficient from such causes. 
The children of this type are seldom well built, but are 
short of stature, and long retain an infantile expression. 
Under this type we have what is called the Mongolian form 
of deficiency. In all these cases the patients are apt to 
show tuberculous tendencies. 

The microcephalic patient presents a deficiency due to 
lack of development of the hemispheres. Some believe that 
microcephaly is an instance of atavism, the appearance of 
a type of brain inherited from some very remote ancestral 

53 



type. A great discussion has resulted from the examina- 
tion of the microcephaHc brain. It has been contended 
that, although the brain is diminished, it shows so distinctly 
traits known only to the human brain that in no case could 
it be taken for that of a lower animal. The brain of a 
microcephalic patient may be diminished in size and de- 
formed, but the characteristics belonging to mankind are so 
marked that the microcephalic, no matter how low he may 
be, is not a beast, but a diminished man. Microcephaly 
precedes birth. Vogt, a disciple of Darwin, thought the 
characteristics of the microcephalic patient resembled those 
of the anthropoid ape. But the intelligence of the monkey 
is very different from that of such a patient. The mental 
powers of the monkey are in perfect accord with his organ- 
ism. His agility in climbing and swinging himself from 
branch to branch is perfectly marvelous. The micro- 
cephalic patients have no power of feeding and protecting 
themselves, and no fondness for climbing. They possess 
the partially effaced lineaments of human beings which only 
a wandering fancy would mistake for those of an ape.* 

Hydrocephalus is the most fatal of the nervous dis- 
eases of children. Many children die of this so-called 
"water on the brain;" some recover without having their 
minds impaired, a few neither die nor recover — these fur- 
nish examples of our lowest grades of deficiency. Some- 
times it comes before birth and often after birth. Epilepsy 
frequently accompanies hydrocephalus. The children of 
this type are apt to be gentle and easily managed.! 

We have convulsions which are not strictly epileptic; 
they are termed eclampsic, but the training and skill of 
the neurologist are needed to differentiate the two. The 
surroundings of the epileptic, his diet and occupation, have 
much to do with his mental condition. We have as yet 
very little knowledge of the disease, because it seems 

* See W. W. Ireland: Mental Affections of Children; London, 1898; 
pp. 96, 97. 

t Ibid. p. 133 et seq. 

54 



impossible to secure the proper surroundings and training. 
It is not well to train him with the children who are not 
subject to the disease, and yet he should not be placed 
where he is shut up entirely with his own kind. The colo- 
nies for epileptics, I think, are the worst things we can 
institute for the obliteration of the disease. If mind affects 
mind, certainly to colonize many epileptics will of neces- 
sity retard rather than promote the possibility of help ; in 
other words, it will increase the disease. When we have 
small state schools and sort out our children, placing one 
epileptic with ten who are not, we will do more to help 
the epileptic than all the colonization will ever do. 

One other division is cretinism, to which I wish to call 
your attention. This occurs frequently; and many who 
know nothing of this form of deficiency are interested be- 
cause of familiarity with the title. It is endemic in the 
Alps, and has been common there since ancient times; it 
is rhost common in shut-in valleys and has a close connec- 
tion with goitre. Nowhere does cretinism exist where 
goitre is not found, but goitre may occur without cretinism. 
There are close valleys where more than half of the chil- 
dren are cretins. Parents living in these valleys will fre- 
quently send their children to elevations to be nursed, and 
this tends to a change for the better. A great improvement 
has been made in many cases of sporadic cretinism, by the 
medical use of preparations made from the thyroid gland 
of animals. This treatment must be watched and the 
effects closely noted by the physician. 

This concludes the present-day classification of the 
mentally deficient, and I want you especially to note that 
those odious terms ''imbecile" and "idiot" have not been 
used at all, though I have touched all forms of mental de- 
ficiency. We have no use for those names of implied con- 
tempt, and if we wish to elevate these weaklings, we must 
avoid terms by which we express their deficiency. There is 
much in a name and the way the name is used. They may 

55 



be called mentally deficient, but many types of deficiency 
occur. 

I cannot leave the mentally deficient without first 
speaking to you of the beautiful characteristics of these 
children — for they are children, although sometimes old 
in years. After seventeen years of close contact and hand- 
to-hand work with them, from the lowest grades to the 
highest, I have as yet to find a viciously inclined child or 
one who could not be helped upward, provided the right 
environment was brought to bear, and the keynote to the 
psychic life was found. We read in the reports of physi- 
cians and in books of their viciousness, of their cruel traits ; 
this is not true and gives to the public a false idea of their 
true characteristics. I will admit that under a wrong in- 
fluence and with those who have not the tenderness to 
bring forth the good traits, perhaps dormant, the mentally 
deficient child will turn on his attendant and fight for his 
rights ; but this will not be done until after he has been im- 
posed upon for some time. 

They appeal to the most tender side of our natures, 
shut in, knowing (as I am sure many of them do) far more 
than they can express, and yet unable to make their wants 
known; unable to tell if they have been unkindly treated 
and imposed upon or neglected; these beautiful souls in- 
closed in poor sickly bodies at times lose control and attack 
those who fail to understand them or who ill-treat 
them. Give the mentally deficient the proper care, kind- 
ness and love, and excepting in some rare types of epilepsy 
he will not hurt or harm any one. The training must be 
judicious, and great but kindly firmness must be brought 
to bear. I am not speaking from a sentimental standpoint, 
but from a purely practical and humanitarian point of view. 

To speak of putting these children out of the world 
is to my mind as unjust and wicked as to wish your next- 
door neighbor dead if he does not come up to your idea 
of physical greatness. We all have our physical weaknesses, 

56 



and we never know when those weaknesses will incapaci- 
tate us, making us useless members of society. 

One thing it is necessary for us to learn, namely, how 
to prevent children from coming into the world with de- 
fective bodies. This can be done by bringing before the 
public the right way of living and by instilling into them 
a knowledge of the physiology and psychology of child- 
bearing. Further than this, we should enforce the unsex- 
ing of all who are unfitted to propagate their kind; but 
when defective offspring once are here, the obligation to 
care for them rests upon us with far greater weight than 
the obligation to care for the normal child. 

We will glance at the morally weak and the morally 
deficient. The general public must grasp the truth that 
moral sense, like every other mental capacity, requires a 
fitting basis of brain structure, and that if this has never 
existed or has been destroyed by disease, a moral sense is 
impossible. You will all admit that there are those who 
have no ear for music, none of the special structures of ear 
and brain through which alone an appreciation of music is 
possible, and that those persons can never develop such a 
capacity, every rudiment of it being absent. Again, we 
have those who have this structure, but it is like the mind 
of the mentally weak, an impaired structure, just as there 
are those who have a certain ear for tone without having 
it sufficiently developed to produce music excepting by the 
most careful and painstaking study. But with this study 
such people may become fairly good musicians. This is the 
difference between the morally weak and the morally defi- 
cient — one can be helped, but for the other we do not feel 
that any plan has as yet been developed which will make 
a permanent impression. Many mistakes are made by con- 
fusing the morally weak with the morally deficient; and 
by placing the weak with those who have a tendency to 
increase this weakness, no improvement is made, and the 
weak thus drift into hopeless deficiency. Many such with 

57 



proper environment and early training might grow to be 
good men and women. I think there is one salvation for 
the morally weak. For the morally deficient as yet we 
have not found any permanent help. In the first place, 
parents and physicians should come to the realization that 
this condition is a disease, and as early as possible the mat- 
ter should be brought plainly to the parents' notice. Then 
the environment should all tend to strengthen the weak 
points and obliterate the evil, I contend that this can be 
done by true psychological training. This training should 
commence in the earliest years of the child. Teachers 
should be trained for this work, and schools should be 
established with this end in view. These children should 
be trained with the view of receiving a technical education. 
The physical development should be well looked to, the 
manual, and finally the scientific training should follow. 
Where the brain powers are brought to bear upon the recog- 
nition of differences and work in the scientific laboratory 
is such as to bring into play the power of concentration, 
the brain structure is bound gradually to change. The 
trouble has been that we give these children "edged tools" 
and only just sufficient education to sharpen their already 
bright and cunning wits. 

Furthermore we should not place them all together, 
but one morally weak child should be placed with ten 
strong, and so with the morally deficient. The morally 
weak will not retard the strong, but the strong will uphold 
the weak. I believe if this course of treatment could be 
tried systematically for the next fifteen years, in twenty 
years the decrease in crime would be incalculably great. 
It would be expensive at first, but not nearly so much so 
as the crimes which are committed by these morally weak 
and morally deficient at the present time. 

In Plato's Republic there is this quotation which is 
truly applicable to this gathering: "I have told you only 
half, citizens; we shall say to them in our tale, you are 

58 



brothers, yet God has framed you differently. Some of 
you have the power to command, and in the composition 
of those he has mingled gold, wherefore they have the 
greatest honor; others he has made of silver, to be 
auxiliaries ; others again are to be husbandmen, and crafts- 
men he has composed of brass and iron; and the species 
will generally be preserved to the children. But as all are 
of the same original stock, a golden parent will sometimes 
have a silver son, or a silver parent a golden son. And 
God proclaims as the first principle to the rules and all 
else that there is nothing which they are to be such guar- 
dians of as of the purity of the race." 

While the bulk of this essay comes from personal ex- 
perience and observation, I am indebted to the writings 
of Drs. Ireland, Baldwin, Newbold, McKim and others for 
the information and help I have obtained from their books. 
In some instances, where their words have expressed the 
thoughts better than I could word them, I have quoted 
from them entire. 



59 



VI 

LIGHT THROUGH BROKEN 
WINDOWS* 



EXPERIENCE is the only road to truth. Leonardo da 
Vinci calls experience *'The Mother of Sciences." It 
is by the vast accumulation of individual experience 
that mankind grew out of primitive savagery to his state 
of modern culture. 

It will be the object of the present essay to present 
some views that are the outgrowth of some twenty years 
of experimental work with mentally deficient children ; espe- 
cially some ideas relating to the "light" or hidden life 
behind human organisms. I will therefore take as the basis 
of my thought that the psychic "light," life and personality 
are one, no matter what you may call it. 

In the lowest forms of life (such as the ameha), the 
beginnings of all physiological processes are found ; for 
example, irritability, contractility, nutrition and reproduction. 

In the growth of the ameba we find the first efforts, 
as it were, when life pushes its way into the sense-world 
by means of a physical manifestation. The human organ- 
ism, the highest of all, makes precisely the same efforts. 
In it the ego — the personality — or the individuality — en- 
deavors to work its way into and become manifest in the 
world of sense by means of the nervous system, just as in 
the ameba we find the manifestations of intelligence in the 
cell-substance, which has no nervous system. 

Therefore, I am with those who believe that which we 
commonly call "the mind" is the soul-light working through 

* Published in the Journal of Psycho- Asthenics, December, 1904. 

60 



and utilizing the bodily organs of sense. In a normal per- 
son the motor and sensory nervous systems act as the win- 
dows of the individual personality. 

As yet, I have not been able to collate completely these 
elements of experience into a scientific philosophy. There- 
fore, the orthodox scientists may think my views unfounded. 
Notwithstanding this possible criticism, I firmly believe 
that the time is near at hand when we shall be able to 
furnish substantial evidence that will prove not only the 
existence of a personality, but of an ego that lives and 
feels, even though its full expression may be obscured by 
an absence, or a disease, of certain portions of the physical 
structure, and that this personality probably persists after 
all apparent physical conditions have disappeared. 

The trend of thought in this direction will also become 
apparent by a careful study of many of our recent works 
on biology and psychology. 

If you read carefully any of these works, or parts of 
all, you can get an idea of both sides of the question as 
to the existence of life with or without the physical attri- 
butes. 

The broken, many-stained and pictorial windows 
through which the light is struggling under disadvantages 
to harmonize itself with the physical world at large are 
found in three classes of persons — the mentally deficient, 
the morally deficient, and the insane. In these, the light is 
there, but the images, as in a broken cathedral window, 
are more or less shattered and confused. 

It is not easy to define clearly what is meant by mental 
deficiency. I have ventured one definition which seems at 
least to avoid some of the difficulties. Mental deficiency 
is the lack of some part (greater or less) of the central or 
peripheral nervous systems, or the incompetency of these 
parts to respond to the efforts of self-expression. When 
this lack is so pronounced that there is little or no acquain- 
tance with the world of sense, we have the very lowest 

6i 



form of mental *'lack," frequently accompanied by some 
great disfigurement of the body. Persons so afflicted are 
called monstrosities. 

In the second grade we have children mentally defi- 
cient from gross brain alteration and not capable of marked 
advancement by reason of absence or serious defect in the 
greater portion of the cerebral hemispheres. Here the 
pathological conditions are such as to be almost irreme- 
diable; and the net result of treatment may be merely the 
modification of some established habits. 

In the third grade are children who are capable of 
greater intellectual advancement than those of class two; 
where the destruction or defect is limited to certain func- 
tioning areas of the brain or of one hemisphere, such as 
the auditory, visual or motor centres. With these there is 
less obliteration of latent or actual mentality, and more 
can be accomplished by training. 

In the fourth grade we have defectives from conditions 
extra-cerebral or reflex, or where there is delayed cerebral 
development either as a whole or in part, without the brain 
being actually the seat of gross lesion. These are fre- 
quently capable of marked intellectual advancement. In 
this grade, deficiencies may have been caused by epilepsy, 
prenatal malnutrition, inherited diseases, or traumatism. 

This is the classification I would suggest, because the 
usual methods of symptomatizing are arbitrary and the 
terms employed undesirable, so that it seems impossible 
to classify these cases except on pathological grounds. The 
class basis must, however, always yield to the individual 
in care and treatment. 

Another grouping of these types is as follows : Hydro- 
cephalic, microcephalic, paralytic, traumatic, sensorial, men- 
ingitic, myxedematous, amaurotic and mentally deficient 
''savants/' Pardon the introduction of these technical terms, 
but this classification is used in many of our institutions 
and asylums. 

62 



Hydrocephalic, microcephalic, paralytic, epileptic, and 
traumatic are very readily recognized by their symptoms. 
Sensorial deficiency is a form due to the congenital or in- 
fantile loss of some of the senses ; for instance, in the cases 
of Helen Keller and Laura Bridgman, sight and hearing. 
Meningitic can rarely be diagnosticated until after death. 
Cretinism I described in an earlier paper. Amaurotic is rare. 

The term ''mentally deficient savants" is applied to 
certain children who exhibit special aptitudes of one kind 
or another that are out of proportion to their intellectual 
development in other directions, and often remarkable as 
compared with similar accomplishments or faculties in 
normal children.* 

This will give you an idea of the different kinds of 
our broken windows and the manner in which the complete 
normal mental picture is obscured. But how are mothers 
and teachers to determine when these windows are broken? 
If possible, start at the very earliest age, and notice what 
is apparent in the normal child, then use this as a basis 
for comparison. 

In the first month of life, a normal child will dis- 
criminate sound; its perceptions will be active as to taste, 
smell, touch, sight and hearing. It should sleep sixteen 
hours out of the twenty-four, and its reflexes should be 
active. A six months' old child should be able to raise 
itself to a sitting posture, crow with pleasure, look into the 
mirror and seem as if it were comparing the image with 
the original. At twelve or fourteen months of age the 
child should stand without support, stamp, begin to whisper 
consonants h, p, y, d, ni, n, r, I, g and k, and especially use 
the vowel a. At the ages of seventeen, eighteen and nine- 
teen months the child commences to associate words with 
objects and movements. It blows a horn, combs and brushes 
hair, and makes other imitative movements. When two 
years of age, it marks with a pencil on paper, pretends to 

* See Popular Science Monthly, December, 1896. 



use a newspaper, executes orders with surprising accuracy, 
beats time and tries to dance to music. 

Now, if you will compare the abnormal with the nor- 
mal, you will very readily see where the deficiencies are. 
However slight they may be, the first thing to do is to set 
to work to remedy them. The ways to do this are many 
and the time too short for me to go into details in this 
paper, since each child requires individual attention. If, 
however, I can be of any help, I shall be glad to answer 
questions, either in writing or by interview; but inquirers 
should always remember that a full outline of the case will 
have to be given before a course of training can be de- 
cided upon. 

In our own school we have individual training in class 
work; each child has individual physical culture and indi- 
vidual discipline. Yet, all of these children are grouped 
in different classes in order to stimulate them by emulation 
and competition. This ideal course can be carried out only 
in a school where there are many teachers for a few chil- 
dren. However, in your own homes you could start some- 
thing like it, if you have the time and patience to devote to it. 

I come now to the morally deficient group. Personally, 
I have not yet been able to estimate properly the exact lack 
in the nervous system that causes moral deficiency, but I 
believe the time is near when we shall be able to diagnos- 
ticate such cases correctly and determine the portions that 
are lacking or diseased, and then we shall be able to apply 
the remedies much more intelligently than is possible to-day. 

I have always held the theory that if we could take a 
morally deficient child in its earliest age and give it a 
special education up to the age of twenty-four, carrying 
it through even the higher grades of education, always with 
the one end in view, to eliminate particular failings, we 
should soon be able to do away with moral deficiency. We 
should train the child especially to be painstakingly exact. 
Let me illustrate by a hypothetical case. A certain girl or 

64 



boy is untruthful and unwilling to carry out any work given 
her or him. Put the child to work, then, to measure exactly 
three inches square, and make a square exactly three inches, 
join the ends, and persist in the exercise until it is done 
correctly. 

The important thing is to be persistent. Never cease 
until the set task is performed, and performed properly, 
even if you have to show the child how to do it a thousand 
times. The ultimate results are worth the labor. If this 
perseverance is carried out in all work, I think you will 
soon have the ''open sesame" to the aboHshment of moral 
deficiency. 

When perhaps after years you have gained a complete 
control over your child's habits, give him a college and then 
a university training in the sciences, especially in zoology 
and botany, and those branches which require microscopic 
investigations. 

This training, accompanied by proper medical gym- 
nastics, is, I believe, the only true help for this class of 
children. 

This may seem an expensive project to you. It is really 
work which our Government might well undertake. Cer- 
tainly, the millions of dollars that are now spent upon 
prisons and reformatories could be better used in support 
of our universities. 

I have been very much interested in the insane, and 
it has been my privilege in the last year to have the oppor- 
tunity of observing some of this class. I would define 
insanity not as the lack of certain portions of the brain, or 
a weakness of the central nervous system, but as a disease 
of these parts after the ego or personality has become nor- 
mally in touch with the world of sense. When such disease 
has occurred, the ego or personality has been repressed, and 
in its endeavor to reach out comes through wrong channels. 
Therefore, we have those ''storms" which are known as 
acute mania. 

65 



These storms in a nervous person or one mildly insane 
remind me of a river that has overflowed its channels and 
is endeavoring to find a course without knowing just where 
to go. Just as we have to find a new channel for the river, 
so we must find a new outlet for the personalities of the 
insane. 

In many instances our neurologists, by discovering the 
physical causes, have been able to do this. Even though 
we cannot find these, we may still be able to discover other 
neural parts duplicated, that have not been in use, by which 
this personality may secure its outlet without causing the 
storms which are apt to occur when it is forced into an 
irritating path. 

Even if the insane cannot always be cured under this 
treatment, I maintain that seventy-five per cent, can be 
made tractable. No matter how beautiful our state asylums 
may be, work of this kind cannot be done in the mass. It 
must be done with small numbers and by trained neurolo- 
gists, aided by helpers with intelligent scientific insight, 
preferably women. 

Can you imagine anything more pathetic, and com- 
manding more fully our truest and deepest sympathy, than a 
personality unable to express itself and yet capable of under- 
standing the ouside world? No matter how maimed the 
body, and how lacking in mental aptitude, perhaps there 
is a very beautiful personality striving to emerge into the 
world of sense, which, with proper machinery for exit, 
might make the patient blossom into a man or a woman of 
letters and renown. 



C6 



VII 

HOME CARE OF CHILDREN 
WHO ARE BACKWARD AND MEN- 
TALLY DEFICIENT* 



Introduction 

THE object of this paper is to present to the parent, 
guardian or teacher, a general outline of what a 
*'Home Course" of training for the mentally deficient 
child should include. Only the general principles can here 
be given, for it is obvious to any one that in dealing with 
children such as we are considering, a special course must 
be devised adapted to each child. No two are deficient in 
the same way; no two, therefore, can be managed in the 
same way. In every case the history of the child should 
be known to those undertaking the training ; and still more 
important, an examination of his physical and mental con- 
dition should be made by skilled specialists before any sys- 
tem of training is formulated. On an intelligent diagnosis 
of the individual deficiency must be based the selection of 
every remedial agency. Some apparently serious defi- 
ciencies are comparatively easy to correct, being dependent 
upon an imperfection in some organ or function of the 
body, which, when ascertained by the specialist in his ex- 
amination, readily yields to proper medical or surgical 
treatment. A common cause, for instance, of apparent 
mental dullness is defective vision, and the services of an 
oculist are needed before anything else is to be done. It 
is obvious, therefore, that to arrange a course of effective 
treatment and home management for a particular case, we 

* Published in pamphlet form, February i8th, 1905. 

67 



must have the history of the child, including a skilled diag- 
nosis. This paper merely presents some general observa- 
tions which may be serviceable in most cases, but can by 
no means fully meet the requirements of the individual. 
Special detailed directions suited to the particular case 
should be formulated to supplement this general outline. 
I trust that those interested in the training of children of 
the class under consideration will see the necessity of hav- 
ing the child examined by a skilled neurologist. Only in 
that way can individual needs be met. 

Formation oif Corre^ct Habits 
(a) Daily Physical Habits 

One of our great psychologists has said that "man is 
simply a bundle of habits;" regulate these habits, and the 
person becomes in a certain sense an intelligent machine 
running smoothly and almost automatically. Hence, in 
dealing with the normal child, the first aim of an intelli- 
gent parent is to form in that child certain habits so con- 
firmed as to be a guiding force in daily life — as some would 
say, "second nature." 

The man or woman who is able to do the greatest 
amount of work in the world is the man or woman whose 
alert intelligence has enabled him or her to form the largest 
number of effective and well-regulated habits. Therefore, 
the first object of the teacher or trainer of a mentally de- 
ficient child (who, of course, cannot act on his own initia- 
tive) would be to establish as soon as possible certain de- 
sirable and necessary habits. The nervous system, however 
impaired it may be in individual cases, can be trained at 
least to degrees of usefulness, the results in many cases 
being surprisingly satisfactory. The child with weak nerve 
centres, and with probably certain areas of the brain in- 
jured or gone, will of necessity require most thoroughgoing 
study and specialized work on the part of the expert, 
whose business it will be to find some nerve centre that 

68 



will, by proxy, do the work of those that have, because 
of defectiveness, refused to act; or to train weak nerves 
into strength and efficiency. 

In dealing generally with mentally deficient children, 
the first aim should be to establish a regular time for the 
daily evacuations. This is of the utmost importance; it 
is imperative that some intelligent and trustworthy person 
should attend to this matter. A nurse girl of the right kind 
can be trained to attend to the child at a regular time each 
morning. If there is no movement, a good warm water 
enema should be given. If this is persisted in day after 
day the child will, unless the case is unimprovable or hope- 
less, form a regular habit of evacuation. If the child is 
not able to do this, there need be no fear of the enema. 
We have used this method of treatment for years with the 
most delicate children, and with marked success. 

In the case of epileptics, it is sometimes advantageous 
to give what is called a high enema or cascade, even if 
there has been an apparently good evacuation. We have 
a child on record, fourteen years of age, who, before he 
came to us, defied all medical treatment of both schools 
and the most watchful care of his mother. He was never 
able to retain discharges or to evacuate at the right time, 
even when the best attention was given by his attendants. 
When he entered our school we originated a method to 
suit the case, and it has proved most satisfactory in results. 
At a regular time every morning we give this boy a good 
hot water enema. This gives the lower intestinal tract just 
what it needs — a washing out, a bath. He has gone as 
long as six months without trouble, and his general health 
has improved wonderfully. No special attention to his 
diet is needed ; he eats as other children do, and with good 
digestion. We defined his case this way: the boy had not 
cerebral power to control the necessary muscles, and a 
natural action in his case resulted in only a partial evacu- 
ation. Later, when the boy went out to play, there was 

(>9 



an involuntary evacuation which frightened and distressed 
him, and this constantly recurring shock to his nerves 
affected his whole physical health. The enema reaches up 
and washes out the colon, and although the boy has not yet 
reached a stage where he can dispense with the enema, 
his organs of excretion have formed a habit just as any 
other habit is formed, and waste matter is ready to pass off 
at the proper signal. In other words, although in this 
case we have thus far been unable to establish a habit of 
mind, we have overcome the unpleasant situation by estab- 
lishing a habit of body through the artificial means — the 
enema. 

An epileptic child has had a similar history. When 
she came to us she averaged two thousand convulsions a 
year. By using, in the way just described, the hot water 
enema we were able to take her through a whole year with- 
out a spasm. After being with us a number of years, she 
left our school and was placed in a large institution, and 
although bromide and other drugs are given to prevent 
convulsions, she sometimes has as many as fifty a day. As 
might be expected, she has retrograded in every way. 

I am firmly convinced of the vital importance of thus 
forming daily physical habits, and of the possibility of 
doing so in the vast majority of cases, if intelligent and 
persevering study is given in the individual instance as 
it comes before us. 

(b) Destructive Tendencies 

Most children who have weak nerves are inclined to 
be destructive. The first thing to get out of our minds 
in connection with this matter is the thought that the child 
do€s this because it is bad; such a child is seldom wilfully 
destructive. He breaks and destroys for the simple rea- 
son that he lacks motor control; the nerves are irritated, 
and there is an impulse to do something. Not having the 
proper inhibitory power, he is apt to destroy whatever is 

70 



in reach. The idea of total or even partial depravity has 
so little to do with these cases, if it has anything, that, for 
all practical purposes in this discussion, it may be ignored. 

The usual plan of removing the objects out of his 
reach is useless as a means of cure, except in rare instances. 
The methods employed vary, and depend upon the mental 
and moral constitution of the child. In our own school 
we do not apply the same method to any two children. 
Yet I think I can safely say that it would be hard to find 
less destructiveness in a family of nonnal children as large 
as ours. 

On general principles, I would wish to surround the 
children with everything they desire to destroy, and so 
satiate them with the amusement they crave that the habit 
would die a natural death; but this disturbing and some- 
what expensive way of exorcising the evil spirit is rarely 
necessary. There are better and more economical methods. 
For instance, we have a little boy who has been with us 
a year. When he came, if he saw a flower, vase or book, 
his impulse was to throw away the flower, dash over the 
vase and tear the book. He is now in a room that is as 
sweet and pretty as can be, and he destroys very little in 
that room. He has been trained to handle flowers and to 
look at books and vases, not to toss or break or tear. He 
does this, except on very rare occasions, under the direc- 
tion and control of an attendant or teacher who uses his 
hand as she would her own if she were handling the article. 
Then he is taught to bring the article to his attendant or 
teacher. If he does this without tearing it, he gets a piece 
of candy, so that gradually he gets an idea of associating 
something pleasant with the occasions when he sees these 
things, but does not destroy them. The process is, of course, 
slow ; but, being founded on a rational knowledge of the 
condition, is sure. 

With other children we use different methods. A little 
girl would in certain nervous paroxysms, break tumblers 

71 



at meal time. For a few meals she was put at a table 
where she had to use a tin cup until "her hands got well." 
When they were perfectly well, so that they would not 
hurt her tumbler, she was allowed to come back again 
and use her tumbler. The method of treatment proved 
speedily efficacious; hand and tumbler were soon restored 
to their former friendly relations. I think I can truthfully 
say that for our twenty-five children we might have twenty- 
five different methods. 

We base the beginnings of our training on the reports 
of parents or guardians; and it is modified as, by careful 
daily observation and study, we come to understand the 
cause of the destructive tendency. This search for the 
cause and for the remedy to meet it is our daily study, and 
a most interesting study it is, putting us in the attitude of 
friend and physician to these pupils of ours, who have a 
diseased tendency that we can correct by sympathetic and 
watchful care. Healing, not punishment, is our watchword ; 
and how beautifully they respond to it ! 

(c) Pernicious Habits 

If carefully looked into there may be found for every 
habit, however pernicious, a physical cause, and our busi- 
ness is, if possible, to find the cause and remove it. If it 
is not possible to do this, there is always some means of 
arresting the habit so that it may not become progressively 
worse; and there is every reason to feel that it may gradu- 
ally decrease with proper training. We have a case of a 
little girl whose habit of self-abuse has been much im- 
proved and who evidently has had great physical relief 
from simply having the parts irrigated every day and thor- 
oughly cleansed with an antiseptic solution. With boys 
we must resort to circumcision, as well as to thorough 
cleansing of all parts and to plenty of out-door exercise. 
All of this is general. As before stated in connection with 
other topics, everything depends upon the special indi- 
vidual case. 

72 



Gene:ral Care as to HYcmNE, Diet, Etc. 

(a) Bathing 

In reference to this matter we probably have some- 
what different opinions from those of the managers of 
other schools of a similar kind. We take into consider- 
ation the fact that, notwithstanding their apparent good 
health, these children are mostly of a low vitality. We 
are mindful also of the fact that there is some nerve or 
brain lesion when there is mental deficiency. Therefore, 
we do not approve of any exercise that would tend to 
reduce this vitality or unduly waste nervous energy. We 
think that ordinarily every healthy child in our school should 
have a sponge bath between blankets each morning. The 
water should be tepid, and after the bath there should be 
a brisk rubbing with a flesh brush. In some cases a mas- 
sage with salt brine should be given, and in others a rubbing 
down with oil. I would not advise giving a tub bath more 
frequently than two or three times a week, except in rare 
cases. Under special direction of a physician, the shower 
bath should be given to those whose condition calls for 
that kind of treatment. For certain forms of heart trouble, 
there should be medical baths. Some of our children are 
benefited by a quiet, soothing oil rub at night. In this, 
as in all other matters, the individual case is studied, and 
that kind of bathing or rubbing is used which produces the 
best results. 

(b) Clothing 

The clothing should, of course, be regulated by the 
weather. It must not be too warm in the house ; but there 
should be plenty of good easy wraps for out-door exer- 
cise. A daily regular routine for in-door employment and 
out-door exercise should be arranged for each special case, 
and the clothing (adapted to the situation and the weather) 
carefully superintended. 

73 



(c) Diet 

Rich pastries, too many sweets, pork, fried foods and, 
of course, tea and coffee should be excluded from the diet. 
There should be certain hours for meals, and nothing 
should be given between those hours. For instance, we 
would recommend this daily programme: 6.30 A. M., a 
glass of new milk; at 7.15, a wholesome breakfast; at 10.30, 
fruit and a good drink of water; at i P. M., dinner; at 
5.30, supper; and for some children a glass of milk on 
retiring. Children of specially delicate health should per- 
haps receive certain kinds of nourishing foods every three 
hours. The articles selected for these children should be 
such as will build up the tissues, nerve cells, etc., and enrich 
the blood. 

Physical Training 

The kinds of physical training are many and varied. 
So important is it that the individual needs shall be borne 
in mind, that it would be impossible, and I might almost 
say criminal, to prescribe any set of exercises for a patient, 
without first making sure of a correct diagnosis of the 
case. The physical training should be such as to develop 
and strengthen the powers and bring them into co-ordina- 
tion; such as would lead to normal heart action, promote 
digestion and do away with " constipation. Certain specific 
head movements may be serviceable in correcting head 
troubles. Each child should receive special individual at- 
tention and have the constant personal supervision of a 
skilled teacher. In our school gymnasium we utilize many 
special devices for individual cases. 

Attention to Obvious Physical De^e^cts 

Circumcision is frequently necessary. There should 
be an examination of the eyes as to the need of glasses; 
examination of the nose and throat as to enlarged tonsils, 
adenoid growths, etc. There may be need for the reduction 

74 



of glands, and in some cases of little girls treatment of 
genital conditions. 

School and Ci.ass Work 

The school work is, of course, largely objective. We 
have small classes, and our specially-trained teachers em- 
ploy every device first to secure attention, then interest, 
and finally to open a channel for graded instruction. This 
requires the greatest tact, persistence and skill. Any object 
which arouses interest, even though it may be only a de- 
structive interest in bad cases, may be utilized as the first 
step in the mental training. We can determine how to 
proceed with the schooling only after we have learned the 
capacity of the particular child. Many details of care and 
management not possible to specify here are needful for 
each individual child after securing a correct diagnosis. 
It is necessary to obtain a methodical history of the child 
from the time of birth, including pre-natal accidents and 
influences, if possible, down to the present moment. Such 
a record should also give an account of diseases, if any, 
which have prevailed in either branch of the family, such 
as gout, rheumatism, diabetes, Bright's disease, tubercu- 
losis, nervous disease or insanity. If the trouble is attrib- 
uted to an accident, the nature and effect of this should be 
investigated in detail. 



75 



VIII 
PRESIDENTIAL ADDRESS* 



THE physical health of the people of the world we con- 
ceive to be in the hands of enlightened and conscien- 
tious physicians. The physician can, by study, by 
scientific training, by interchange of ideas with others simi- 
larly interested, by advocating wise legislation, safeguard 
the sanitary interests of the community, the state, the 
nation; in just the same way the teachers of our land may 
stand as a great bulwark of strength and protection be- 
tween the American people and threatening dangers result- 
ing from inherited mental and moral weakness and disease. 
Just in proportion as they realize the importance of their 
mission and are suitably equipped for carrying it out, just 
in that proportion will the number of really efficient men 
and women increase, and the number of the inefficient, the 
incapable, correspondingly decrease. For long years the 
problems that face the teachers of normal children have 
been met and discussed, with varying degrees of intelli- 
gence, and valuable additions have been made to the educa- 
tional principles that obtain in our schools and colleges 
to-day. It was reserved for comparatively recent times 
to direct attention to subnormal types of intellect, and to 
formulate principles adapted to the much more complex 
and difficult task of developing the powers latent in the 
intellectual and moral constitution of a relatively small, but 
numerically large, class of persons who come into the world 

* Read before the Department of Special Education of the National Educa- 
tional Association, at Asbury Park, N. J., July 5th, 1905. See Proceedings of 
the N. E. A. 1905, p. 883. 

7^ 



handicapped by mental and moral deficiency. Moreover, 
as the importance of preventive measures is yearly becom- 
ing more fully realized in the medical profession, so in the 
educational field it is being more clearly apprehended that 
the general dissemination of certain fundamental princi- 
ples will lead to a constantly diminishing number of children 
of defective mentality. The future parents of our nation 
need to know the cause and prevention of mental weakness 
and disease — a matter of even more vital importance in 
striking at the root of the evil than any or all of the cura- 
tive agencies that devoted men and women have spent 
their lives in bringing to full efficiency in dealing with those 
who have already come into the world with this terrible 
handicap in the race of life. 

As a result of my own experience and observation, 
I have ventured to offer a few suggestions that it may be 
well to consider. In the first place, to secure the best 
results from the work in which we are specially interested, 
we should introduce and maintain as far as possible, strictly 
scientific methods. ''Scientific thought," says Clifford, "is 
not an accompaniment or an addition to human progress; 
it is human progress itself." In pedagogy, as in any other 
science, we must ascertain our facts by the most careful 
observation, then correlate and classify them. By so doing 
we shall secure a fund of knowledge which we can turn 
as a searchlight, if I may so express myself, upon many 
of the difficult problems of the day. Surely in no branch 
of the educational work of our country has there been so 
great progress during the last five years as in that of the 
department of special education. We have passed the stage 
in our history when teachers of normal children, and indeed 
people in general, looked upon us as engaged in inferior 
educational work. Even the great universities are now 
willing to acknowledge that they have much to learn from 
us, and their departments of psychology look to us for data 
to help them in solving some of their most interesting 



problems. Moreover, as a result of just such national meet- 
ings as that which now calls us together, the world at large 
more fully appreciates the necessity of the efficient mental 
and moral training of the youth of the present generation 
who will be the parents of the next, in order to prevent 
their offspring from entering the world with the heavy 
handicap of some physical or mental deficiency. The time 
is near at hand when our aims and, let us hope, our achieve- 
ments will be seen in their true light, as of vital importance 
to the well-being of the human race. 

As a result of years of experience, I am convinced 
that no teacher should be entrusted with the care of sub- 
normal children who has not had some years of experience 
in classes of children of the usually healthy mental type, 
and that such teachers shall have shown special powers 
of adaptability, insight, and sympathy, such as are con-, 
stantly called for in dealing with the class of children in 
whom we are especially interested. Not inferior ability, 
not even average ability, but the zrery best, should be sought 
out to do the specially difficult work in our schools. In 
this connection I wish to indorse with great heartiness an 
idea for which Miss Campbell, of the University of Chi- 
cago, is responsible. Success in teaching children in our 
schools for the subnormal should receive the same recog- 
nition from the state in the way of testimonials for efficient 
work as is given to those who have taught successfully in 
the regular schools. This will encourage first-class teachers 
to seek positions in the schools in which we are interested; 
moreover, this is a matter of simple justice, and we must 
work for its accomplishment. 

Another idea which I think should recommend itself 
to the fair-minded is that state institutions should b€ pro- 
vided primarily for the indigent who at the same time are 
physically or mentally deficient. There are in the United 
States to-day thousands of feeble-minded children, not to 
speak of the deaf and the blind, for whom the heads of state 

78 



institutions refuse to make provision on the plea of lack 
of room. Yet in these same institutions pay pupils are 
received for amounts ranging from $500 to $800 per year. 
It would be far better, it seems to me, to provide for the 
indigent first, and divert such pay pupils to the small pri- 
vate homes where they could get that individual care and 
attention which will always and inevitably give such home 
schools an advantage over any public institution, where 
''herding" cannot be prevented, with all its attendant evils. 
In these smaller schools the work is of a character for 
which women are peculiarly fitted, and there will always 
be a sufficient number of capable women to undertake such 
training, if only there be a reasonable assurance of ability 
to finance the schools. 

Another fact needs to be impressed on the public mind, 
especially on the wealthy who are disposed to be philan- 
thropic; there is a strong need of endowed schools; there 
is, perhaps, an even greater need of endowments for the 
support of investigators in both the private and public in- 
stitutions — investigators who shall study the patients from 
the standpoint of psychology and medicine, and from the 
data thus collected secure knowledge for the guidance of 
future generations. We have reason to believe that, with 
increasing knowledge among the masses of our people, 
there will be a marked decrease in the number of children 
born into the world with the handicap of physical and men- 
tal deficiency. Our private and public institutions for the 
deaf, the blind, and the mentally deficient must work hand 
in hand ; and money could not be better spent than in scien- 
tific research along these lines. The usual method of dis- 
seminating information in printed form might well be sup- 
plemented by stated public meetings at which those with 
expert knowledge could set forth, in the simplest and least 
technical language, information essential to those preparing 
for the duties of parentage. By such means we may hasten 
the time when the bitterness and broken hearts consequent 

79 



on the advent of afflicted children shall be rare, if not wholly 
a thing of the unenlightened past. 

Without undervaluing the work of our fellow-laborers 
all over the land in schools for normal children, we feel 
that we can magnify our own office; for are we not daily 
called upon to walk in the footsteps of Him who came into 
the world "to heal the broken-hearted, to preach deliver- 
ance to the captives, and the recovering of sight to the blind" 
— captives to ignorance and incapacity, blind to the beauties, 
the mysteries, the glories of nature and art, shut out from 
the rich realms to which their happier brothers and sisters 
have free and easy access? Every wise word you can 
utter, my friends, every plea you can advance in behalf 
of these afflicted children of our common Father, will be 
in the nature of a second evangel. May all that we say 
and do be prompted by a spirit of clear and reverent appre- 
ciation of the seriousness and importance of the work in 
which we are engaged. 



80 



IX 

THE CHILD WHO HEARS. YET 
CANNOT TALK* 



TWO weeks ago to-day I opened a discussion at the 
Women's Medical Association in Philadelphia, on a 
paper entitled "The Child." The thought that I de- 
sired to establish in the minds of those who honored me 
by their attention was that, no matter how broken or de- 
formed the body of a human being may be, within that 
body is a personality, and it is our business to liberate this 
personality from its prison — to remove the obstructions that 
prevent the assertion or expression of the individuality. 

In reference to the development of speech in the defi- 
cient child, my basic thought is, that we must arouse the 
personality of the child and stimulate whatever imperfect 
power may be found, thus aiding the personality in finding 
its way out into the world of motion and sense, of which 
it should form a part. It will be my endeavor, first, to 
make plain to parents and teachers the process by which 
a normal child, or a child with a so-called normal body, 
is able to make its thoughts known through speech ; sec- 
ondly, how the teachers of deficient children endeavor to 
find out what may keep the personaHty of such children 
hedged in. If examination reveals broken nerve fibres, or 
the absence of certain nervous structures, it will be our 
place so to deal with the personality of the deficient child 
as to enable it to utilize for itself other outlets through 
which we may know what its thoughts are. 

* Read at the meeting of the American Association for the Study of the 
Feeble-Minded, Waverly, Mass., June 6th, 1907. 

81 



If there is one physical power which may serve as a 
standard by which man can be truly measured, a power 
which places him above the dumb animal — it is the faculty 
of speech. The immeasurable distance between man and 
every other animal on earth is fully accounted for by the 
existence, the nature and the significance of mind-words. 
Regardless of the physical study, the faculty of speech con- 
sists less in uttering words than in the power of making 
words. Therefore, the faculty of speech is primarily the 
capacity for making words, and words can come only from 
personality, or mind, or the ego, or whatever you may call 
it. Apart from personality, the power of speech has no 
existence. Words are the outgrowth of a meaning, just 
as a knife was first made by some one who wanted to cut. 
Words grow old and die. Some of the finest languages 
ever spoken are now dead. Therefore, it is not words that 
concern us, but the capacity for making them, and this is 
the faculty of speech itself. No speechless race of men has 
yet been found. Not the least impressive fact about this 
exclusively human faculty is its limitless power of creation. 
It would take too long to show all that the philologist has 
learned about speech ; but the more we read and under- 
stand the more convinced we must be that the source of 
all words is a conscious mind, the personality itself. The 
mind's activity comes first, and is the beginning and cause 
of the word. We need to emphasize this primary truth lest 
it escaj>es us : those mental energies originate the words 
which are perceived objectively on the one hand, or are 
transmuted into motor impulses on the other, in brain areas 
upon which we may place our index fingers. Otherwise, 
we might infer that these material localities, these speech 
areas of gray matter, do themselves originate the words 
which are located there. We shall find instead that the 
material centres for words in the brain substance no more 
make those words than the shelves of a library make the 
books arranged on them. The ultimate fact is rather, as 

82 



revealed by the physiological study of the faculty of speech, 
that words are the instruments which the thinker invents 
or makes for himself for the purpose of defining his thought. 

As to the words themselves, we now want to know the 
relation of words to the physical brain, and it is to our 
physicians that we owe the discovery of the localization 
of the brain areas of speech. Through physiologic experi- 
mentation and clinico-pathologic studies, physicians have 
been enabled to determine the various brain centres and 
nervous pathways of the speech mechanism. From their 
discoveries we have learned that the nervous mechanism 
of speech is two-sided — namely, sensory and motor. Words 
come to us through the ear and locate themselves in what 
is called the first temporal convolution, which is in the cor- 
tical area of hearing. Here the verbal memories are said to 
be arranged, figuratively, much like the shelves of a library. 
Then we have words which come to us through the eyes in 
reading. They come to their special locality, which is called 
the angular gyrus, and this is in the cortical visual area. 
Sound words and sight words are thus registered in dif- 
ferent parts of the brain. Then, too, we find another word 
register for the sense of touch. The blind are enabled to 
read in this way. 

The motor side of the speech mechanism is concerned 
either in vocal utterance or in writing. This is styled propo- 
sitional speech, because propositions or ideas are transmuted 
into motor impulses. We require a different mechanism 
for this, because it introduces muscular movement; we 
therefore call it motor speech; this is located in a different 
place in the brain cortex, in the place where muscular move- 
ments are initiated, near the regions which govern the move- 
ments of the tongue and other organs of articulation and 
close to the areas which govern the hands. The propo- 
sitional speech centre is found in Broca's region, a cortical 
area no larger than a hazel nut and located on the left side 
of the brain, in right-handed persons, and on the right 

83 



side in left-handed persons. This area of the brain was 
named after a French surgeon who first identified its con- 
nection with speech. The sensory speech areas (for the 
perception of spoken or written words, etc.) are, as has 
been said, like the shelves of a library. They are there 
waiting to register the words, and when we take up differ- 
ent languages we must put in new shelves. It has been 
positively proved that a man who was conversant with 
English, French, Latin and Greek, was through word blind- 
ness able to read only a very few words in English; then 
he tried French, and he could do somewhat better in that 
tongue, then he tried Latin and did still better, and when 
he took up his Greek he was fluent, showing that the part 
where his English words were registered was almost de- 
stroyed, and the part where his Greek was registered was 
intact. This is a revelation of what we can do ourselves. 

It should be noted that no part of the human brain has 
any original or native connection with the gift of speech; 
this great faculty is always acquired — no one was ever 
born with this power. Man has the various convolutions 
in pairs in both hemispheres, and yet man uses only one 
of the two centres of speech. If in early life the cells of 
the left hemisphere have been injured, then the child uses 
those of the right, and they become the seat for speech. 
In most people the entire word mechanism, in all parts, is 
found only in one of the two hemispheres, while the other 
hemisphere remains wordless throughout life. The active 
centres are usually located in the left hemisphere. Thus, 
part of the left superior temporal convolution hears words ; 
part of the left angular gyrus perceives words; and in 
Broca's region, ideas are changed into motor impulses that 
pass to the tongue, lips, larynx and other portions of the 
voice mechanism. There is also a centre for writing in 
the motor region of the brain. 

Now, the left side of the brain, originally, was exactly 
like the right side, but people took to using the right hand, 

84 



and this has developed the left side of the brain. In the 
relations of men, one personality longing to communicate 
with another uses his hands in making gestures. Gesture 
was, therefore, the first form of language. If we look at 
the centres we shall see that the area governing the move- 
ment of the hand in the motor region of the brain is very 
near the centre which presides over the movements of the 
face, of the lips and of the tongue. We can thus see how 
readily facial expression, allied to gestures, in attempts to 
communicate, will produce sounds from the lips and tongue, 
and they will become words. And as the right hand is 
more often used to makes gestures, the centres have Been 
located in the left brain. 

Now, there is one fact to remember; that is, the plas- 
ticity of the matter of the brain cortex ; in other words, its 
capability of education, its educability; thus the personality 
can modify the brain. Hence, a strong personality may be 
able to make a good brain out of a poor one, but a per- 
fectly formed brain will not make a strong personality out 
of a weak personality. 

I want to say just here that neither you nor I can say 
what kind of personality is in the mentally deficient child 
until we open the doors of the prison house. I also want 
teachers to understand how much is involved in producing 
speech in a hearing child who does not talk. And, briefly, 
I want to say something of the work of the central nervous 
system. But we must consider how we are going to fill 
these shelves with books ; that is, with words ; this is done 
in a normal child through the central nervous system. 

We have now considered how the personality may im- 
press the cortex of the brain and establish the centres of 
speech, or, as we have termed them, the shelves in which 
we place the different books, as it were; but we have not 
yet considered what was involved, in a physiological sense, 
in getting these books on the shelves. 

The interior of the brain is a mass of connecting nerve 

85 



fibres of three kinds, projection, commissural and associ- 
ation fibres. The projection fibres are projecting, so to 
speak, upon the cortex of the brain, and convey sensory 
impulses from the special sense organs. There are also 
motor projection fibres which project the stimuli from cer- 
tain motor areas upon the cells in the spinal cord, and thence 
indirectly upon the muscles. The commissural fibres are 
those which join like parts of the two hemispheres and 
enable these parts to work in unison. We now come to the 
third class, association fibres, the most important for the 
psychologist. These fibres connect different convolutions 
in the same hemispheres. If anything should injure these 
fibres, perception, memory and thought might be impossible. 
In other words, these association fibres take the different 
sensations and make them into one whole sensation. The 
optic nerves pour their stimuli into cells in one part of the 
brain; the auditory, tactile, gustatory nerves to still other 
parts, and it is the function of the assocation fibres to fuse, 
as it were, these various stimuli into a single concept. 
These important fibres furnish the physical basis of asso- 
ciation. 

One can readily see from this how the whole nervous 
system is a network of nerve currents coming in and going 
out, on sensory and motor nerves, and how all these nerves 
connect in different ways to aid the personality in sending 
its messages and giving its thoughts out to the different 
parts of the speech centre, and how the association fibres 
work to fuse the different parts into a whole. It is one 
of the most beautiful pieces of mechanism any one can pos- 
sibly imagine. 

In other words, we have what we call the afferent 
nerve, which sends a current to a centre, and the efferent 
nerve, which transmits from the centre some nervous vibra- 
tion. All these nerve centres are connected by short nerve 
fibres. Now, one important principle to bear in mind is 
that the afferent segment of the nervous system, or that 

86 



which transmits stimuli from the outside world, is the ulti- 
mate fashioner of the nervous system habit, and not the 
central system itself nor the efferent segment. 

From this brief survey of the mental mechanism, 
parents and teachers can see the necessity of knowing that 
there may be a thousand breaks in the mechanism of the 
hearing child which may prevent a personality from pre- 
senting its thoughts to the outward world in words. In 
the case of the deficient child, the disability is correspond- 
ingly greater. 

When we view even briefly the wonderful mechanism 
of the central nervous system, and of the incoming, habit- 
forming stimuli along the afferent nerve fibres, and of the 
outgoing motor results, we are amazed at the intricacy of 
the agencies involved in speech. Can there be a greater 
work in any university or college than to build and engineer 
the delicate bridges and pathways by which you and I shall 
call forth the thoughts of the imprisoned personalities 
buried in the debris of broken nerve fibres, or powerless in 
expressing because of the absence of parts of the requisite 
physical structure? 

But great as is the undertaking, it can be accomplished ; 
we can, if we will study closely, find the keynote of every 
personality entrusted to our care. When we find this key- 
note, we must study the physical structure of the body and 
combine with this a knowledge of psychology. Then we 
shall be able to build our bridges, and not until then. With 
this knowledge we must have wisdom. The teacher who 
undertakes to call forth into intelligent activity the hidden 
personality must have a fullness of information far beyond 
the ordinary knowledge of the principles of articulation. 
First must come the physical education of the body, a well- 
directed system of scientific manual training with co-ordi- 
nated sense training; and then the articulation work may 
bring response. 

If you and I could impress the public with the scientific 

87 



truth that behind these broken structures may be mar- 
velously interesting personahties, we should have no diffi- 
culty in establishing endowed schools, equipped with every 
scientific apparatus, under the most skilled engineers, to 
aid us in producing the artificial structure when the natural 
function is lacking, in order to bring out and develop in 
this sense-world of ours these hidden personalities. We 
cannot close with a better sentiment than that of Profes- 
sor Huxley : 

''After passion and prejudice have died away, the same 
result will attend the teachings of the naturalist respecting 
that great Alps and Andes of the living world — man. Our 
reverence for the nobility of manhood will not be lessened 
by the knowledge that man is in substance and in structure 
one with the brutes, for he alone possesses the marvelous 
endowment of intelligible and rational speech — thus he 
stands as on a mountain top, far above the level of his 
humble fellows, and transfigured from his lower nature, 
by reflecting here and there a ray from the infinite source 
of truth." 

This idea of personality or ''power behind the throne" 
has been most ably expressed by Dr. W. Hanna Thomson 
in his book called "Brain and Personality." Wherever his 
language has expressed the thought that I wished to con- 
vey, I have used it. Every idea of his is my own, and has 
been for years. 



88 



X 



THE MIND OF THE SUBNORMAL 
CHILD AND ITS LIBERATION* 



THE paper read at your last meeting dealt with the 
mind of the normal child. I wish to present to you 
to-night a study of the mind of the subnormal child 
and its liberation. 

In one of his essays Bacon has said: "I had rather 
believe all the fables of the Legends and the Talmud and 
the Alcoran than that this universal frame is without a 
mind." To me this brief quotation contains in a nutshell 
the whole philosophy of mind. It expresses the keynote of 
my conclusions regarding the mind of the subnormal child. 

Let me begin by making clear to you what I mean by 
the word mind. As it is commonly used, this word varies 
greatly in meaning. Webster's Dictionary tells us that 
mind is the understanding or intellect; that which judges 
and reasons; again, that it is the soul. 

The earlier psychologists interpreted mind as conscious- 
ness and its capabilities, both acquired and innate; or, in 
other words, the functional activity of brain-tissue. But 
in recent years psychologists have been forced to admit 
that mind extends beyond the confines of consciousness. 
The term has therefore been extended to include those sub- 
conscious or transliminal phenomena which affect conscious- 
ness. 

The philosopher goes further in his definition of mind. 
He uses the term in general as an antithesis to matter. He 

* Read at a meeting of the Home and School Association, Swarthmore, Pa.,. 
Jantiary 4th, 1909. 

89 



calls mind in this sense that part of reality "which does 
not admit of exclusive interpretation in terms of matter 
and motion" (Baldwin). 

The theologian's definition is even more all-embracing. 
Mind, as interpreted by him, includes not only the psycho- 
logic, but also the philosophic phases. But to him the latter 
is much more definite and concrete. He believes mind to 
include ''the non-corporeal and spiritual individuality of 
man" (Baldwin). We might continue to present defini- 
tions, interpretations and viewpoints regarding mind suffi- 
cient to fill a volume. We must be content, however, with 
the four general views just mentioned: first, the common 
definition; second, the psychologic; third, the philosophic; 
and fourth, the theologic definition. 

For twenty-five years this problem has been one of 
absorbing interest to me. I have viewed it not only from 
the abstract and theoretical standpoint, but also, and more 
particularly, from the standpoint of practical effects and 
results in educational work. In its relation to the mind 
of the subnormal child, I have examined it perhaps more 
closely than any other investigator, and I feel that I have 
ample basis for my conclusions. 

Now, what is the real child? Is it the physical body? 
No. Is it the psychologic mind — ^that complex of sensa- 
tion, perception, association, memory and other related fac- 
ulties? By no means. It is the higher plane, that portion 
of the individual which, according to our philosophic defi- 
nition, "does not permit of exclusive interpretation in terms 
of matter and motion." This I believe to be the real child, 
and I call it the personality. 

I do not mean by this that the personality is the whole 
child. The body and the psychologic faculties are neces- 
sary to complete the individual. I mean that the personality 
is the moving power, the molding and formative influence 
which determines what the individual shall be. It is, as 
it were, the cause which uses the body as a means to the 

90 



ends of life. Thus, it does not depend for its existence 
upon the physical body; nevertheless, without the latter 
its manifestation in the world of sense would be impossible. 

The child's real worth should be measured — if this 
were possible — by the personality rather than by its exter- 
nal manifestation, for, as was said, the latter depends on 
the physical only, whereas the former depends chiefly upon 
the hereditary racial and family characteristics and the 
many modifications that ancestral environment has exerted 
upon them. 

It is my conviction that mind is more than mere physio- 
logical function. I believe that we are bound to recognize 
an element which for the want of a better term I may call 
psychic. The theologian's definition thus comes nearer the 
truth than any other. 

I would define mind as that portion of the individual 
being which is composed of the personality and the psycho- 
logic faculties through which it is enabled to express itself 
in the external world — the faculties which are so often 
considered to be the whole of mind. 

With this definition as a basis, let me point out to you 
the difiference between the mind of the normal and of the 
subnormal child. The difference lies solely in the psycho- 
logic faculties, which are dependent upon perfection of 
physical structure. These are but a small portion of the 
mind — really no more than the outward indications of its 
existence. In the higher mind — the child himself — the per- 
sonality, there is no difference. In fact, the personality of 
the subnormal child may be much more wonderfully beau- 
tiful than that of many so-called normal children — but its 
beauty is hidden in a broken, maimed and imperfect body, 
which paralyzes its expression and prevents us from seeing 
its real possibilities. 

The subnormal child is a child whose personality is 
imprisoned in its own brain-cells. Many of us fail to 
realize how dependent we are upon our physical selves. 

91 



If a bone is broken or a tendon cut, the part involved be- 
comes functionless — we cannot use it. But does that cause 
a defect in our real selves ? Are we any less whole in mind 
on that account? If a nerve-trunk to the eye, the ear or 
the larynx is severed, or if a brain-centre is isolated and 
left to degenerate by the pressure of a blood-clot, our power 
of outward expression is impaired or destroyed. But does 
that mean a defect in the personality ? By no means. When 
we look at a helpless, mentally subnormal child, we should 
think, not of the broken nerve-pathways and imperfect 
senses, but of that which lies within and above them. How 
can we know what great things may be hidden there ? Those 
who regard the physical body only, will say: ''This child 
is an idiot, an imbecile; he is deficient." Let us cry shame 
that they, in their blindness, should use such terms. There 
are no idiots ! There are no imbeciles ! There are merely 
broken, crushed and imperfect little bodies, made so either 
by our ignorance or our carelessness, which perhaps im- 
prison minds whose possibilities are much greater than our 
own. 

You will doubtless wish to know upon what founda- 
tion this hypothesis of a personality within the physical 
body is based. I can answer only by referring again to 
that much-abused term "psychic." My reasons are not 
reasons that can be measured and demonstrated experi- 
mentally in the present state of our knowledge of the sub- 
ject. We are not dealing with a measurable entity, but 
with one which, to quote again, "does not admit of exclusive 
interpretation in terms of matter and motion." 

First, I believe it may be shown conclusively that what 
is termed "character," which no one will deny is a part of 
the mind, bears very little relation to the degree of physical 
or psychologic defect. I have seen many cases of children 
who were unable to utter a single intelligible word or to 
perform a single adequate act of self-help, but who showed 
in ways that could not be misunderstood force of character 

92 



far beyond many normal children. Some one may perhaps 
say this merely demonstrated that part of the central ner- 
vous system remained intact. But where, I ask, is the cor- 
tical centre of character, or of will, or of affection, or of 
zeal for right and justice? Every brain-centre in the nor- 
mal child is involved in the expression of these, and when 
they show more than normal vigor in spite of an imperfect 
brain, I hold that nothing but a personality such as I have 
described can account for the facts. 

One of the first things which called my attention to 
the possibility of the existence of a personality was a phe- 
nomenon which is more or less familiar to every one. I 
refer to the change which takes place in facial and bodily 
expression after death. We once had a little girl in our 
school who was a cretin. Her body was dwarfed and de- 
formed, and her face appeared not to have a single line 
of beauty in it. And yet she showed a strong personality 
to those who knew her. The little girl died, and I was 
greatly surprised to note, a few hours after death, a re- 
markable change in her expression. All the deformity, 
every sign of pain, had disappeared, and her face was an 
almost perfect image of that of her sister, who was very 
beautiful. Perhaps you may think this impression due to 
sentiment, or to the relaxation of the tissues accompanying 
suspension of respiration and circulation, but I cannot be- 
lieve that these would account for it, and I have seen it 
many times in widely varying cases. It is my opinion that 
death permits the true personaHty to go forth into outward 
expression, the defective functions of conscious life no 
longer interfering. 

I have convinced myself, furthermore, that subnormal 
children possess psychic faculties which bear no relation 
to the type or degree of subnormality. I have in mind the 
case of a boy who was exceptionally defective. He was 
deaf, mute, partially blind, and so deformed as to be almost 
replusive to a stranger. And yet wonderful things were 

93 



in that boy. I found that he had the faculty of reading 
my thoughts. Again and again I made the experiment of 
hiding something that he liked and then telling him to 
find it. At first he would sit perfectly quiet, but soon he 
would begin to look about, and it was seldom that he could 
not go directly to the spot and find the hidden article. 

I have known many such cases. Some of them ap- 
peared to be cases of simple telepathy. In one instance, 
I awoke at two in the morning, with the feeling that one 
of my little girls needed me. The impression was so 
strong that I finally got up and went to her room. I found 
her sitting up in a very uncomfortable position. The at- 
tendant had fallen asleep and left her there. The child 
did not know enough to get up and go to her bed, and yet 
she was able to impress me with her need. Perhaps you 
will say that this was a coincidence, and if the case were 
an isolated one I might agree with you. But I have had 
countless similar experiences. In fact, if I am in need of 
rest and wish to get my mind entirely off my work, I am 
forced to go away to sleep. I cannot find any relation be- 
tween these phenomena and the physical brain ; and if they 
are not brain-functions, what are they? Again I must say, 
they are manifestations of personality. 

Finally, let me say that my hypothesis works. It pro- 
duces results. If I were convinced that a great treasure 
lay hidden in the earth, I would spare no effort to uncover 
it. But if I had no belief in its presence there, I would be 
foolish to waste time with a pick and spade. So it is with 
the personality of these children. Being convinced that it 
was there, I have sought by every means to draw it out, and 
I have succeeded many times when failure would have been 
inevitable had I doubted its existence. 

With these convictions, you can understand why I feel 
that the tenderest care and most patient and thorough train- 
ing are none too good for these children. It is their right. 

94 



And their helplessness makes the granting of this right a 
solemn duty. 

The problem of educating the subnormal child is, as 
I have said, one of liberation. It becomes a question of 
reaching the personality by any means that will serve, 
through the physical body. Correction of the physical de- 
fects will be followed by development of the psychologic 
mind, and the personality will then find its way out into 
the world. 

In this work much more than purely pedagogic knowl- 
edge is required. The educator alone cannot cope with the 
problems that arise. The psychologist and the physician 
must come to his aid. As the years have passed, I have 
learned more and more the truth of this, and it has forced 
me to acquire much of the more practical knowledge of 
both of these specialists. 

Within the past eighteen months we have added to 
our staff of workers a physician who is also a psychologist, 
and he has been able to assist me much in the work. We 
cannot do all that we would, on account of lack of means, 
but we look forward to the time when an endowment will be 
given us which will enable us to enlarge our experimental 
laboratory and to establish a training school for teachers 
who may thus carry the work into other and wider fields. 

I am going to ask our psychologist, Dr. E. A. Far- 
rington, to tell you something about the methods we use 
in our school in accomplishing the results which we are so 
firmly convinced are possible in subnormal children — results 
the real value of which none of us can estimate. What 
these little ones that come to us with broken and imperfect 
bodies really are, we cannot tell. Their worth can be meas- 
ured only after the physical body is laid aside and they 
stand erect in the Kingdom of Heaven, where *'the first 
shall be last, and the last first." 



95 



XI 

THE LEAKAGE IN OUR EDUCA- 
TIONAL SYSTEM* 



DURING the last decade the great body of water flow- 
ing over the falls of Niagara has decreased so 
markedly as to threaten the integrity of this mag- 
nificent wonder of nature and to fill the hearts of those 
who love and reverence its beauty with fear lest it be 
entirely destroyed. 

The eyes of a whole continent have been focused upon 
the Niagara river, and public indignation has forced an 
investigation that brought to light the exact extent and 
cause of this great leakage. Nor has popular sentiment 
rested here. The weight of public opinion has been brought 
to bear upon those whose lack of consideration for the 
public welfare has led them to turn the river water into 
their private turbine systems, and an effectual means will 
be found to stop the leak. 

In the great onward flow of our educational stream 
a far more important leakage may be found than the one 
occurring in Niagara. This leakage is so extensive that the 
stream passing through the public schools is reduced to 
scarcely more than one-quarter its original volume, the lost 
m.aterial leaking out into the streets, the jails and the cus- 
todial schools, or else backing up and impeding the progress 
of the incoming stream. 

An alarmingly large proportion of our children fail to 
complete even the small educational preparation for life 

* Read at the 34th annual meeting of the American Academy of Medicine, 
Atlantic City, June 5th, 1909. 

96 



required by the state. Few of us are fully aware of these 
facts, and very few are even partially acquainted with the 
reasons for the condition and the causes underlying it. 

The Russell Sage Foundation of New York City is 
now conducting a series of studies of public school chil- 
dren with a view to determining why children fail to 
advance in the grades. The statistical part of this inves- 
tigation, which is in the hands of Mr. Leonard P. Ayres, 
has brought to light some surprising figures. He found in 
an examination of 20,000 children in fifteen schools of Man- 
hattan, taking into account increase in population and loss 
by death after entering school, that for every 1,000 children 
in the first grade there were only 259 in the eighth grade, 
or about 511 less than there should be. Furthermore, he 
found 456 more children in the first grade than should be 
there if all advanced normally. 

There are two closely related factors in this loss, 
namely, retardation, or dropping back, and elimination or 
dropping out. Mr. Ayres mentions several causes, three 
of which are important. They are late start, language diffi- 
culty and physical defects. His studies showed that late 
start is a small factor and that the language difficulty ex- 
perienced by foreign children is unimportant. His exami- 
nation of the records of physical defects brought to light 
the remarkable discovery that more defects occur in nor- 
mal than in retarded children. Much might be said re- 
garding this question of physical defects. The figures given 
by Mr. Ayres were unfortunately based upon rather meagre 
data, as there were comparatively few recorded physical 
examinations of the children studied. It is probable that 
a more careful and thorough examination of the retarded 
children would bring out many slight structural or func- 
tional abnormalities of the kind that are almost always 
overlooked in routine physical examinations made by the 
ordinary school physician. While slow progress in school 
is often attributed to physical defect, the blame is all too 

7 97 



commonly laid upon the mind of the child. Mothers and 
teachers will say : "Yes, Johnny is perfectly well, but he 
is so dull and inattentive that we can do nothing with him." 

This brings to me what I believe to be the chief cause 
of the leakage in our educational system. 

Plato says: '1 maintain that ignorance is the ruin of 
states, and if this be true, legislators should seek to im- 
plant in them wisdom and banish ignorance."* 

It is ignorance that overcrowds the lower grades of 
our schools; that populates our streets with delinquents; 
that fills our custodial schools ; and that forces us to enlarge 
our county jails and state prisons. And where is this igno- 
rance to be found? Among the children? Yes, perhaps. 
But we are sending them to school ; why, then, do they not 
learn ? 

The answer is not hard to find. Teachers, parents, 
physicians, school superintendents, legislators — all must 
share the responsibility of this failure. 

Parents are but rarely acquainted with even the simplest 
facts of parenthood, and are sadly ignorant of the signifi- 
cance of diet and hygiene in the care of their children. 
Teachers are but seldom informed as to the relation of eye, 
ear and throat defects to mental aptitude and of the vital 
part played by the nervous system in the growth of the 
body and the mind. 

Professor Hugo Munsterberg, in his essay on Educa- 
tion,f deplores most justly the inefficiency of American 
teachers, and their lack of solid scholarship. He points out 
further how necessary is the co-operation of parents with 
the work of the school. "It is a noble thing," he writes, 
"that Americans put millions into new school-houses; but 
to build up the education in the classroom without a foun- 
dation in the serious, responsible aid of the parents is not 
better than to build those magnificent buildings of brick 

* Dialogues of Plato: Laws, Book III. 
t American Traits, p, 43. 

98 



and stone on shifting sand."* Parents and teachers must 
work hand in hand. Ignorance of the elementary facts of 
Hfe, growth and education on the part of either one may 
result in grave injury to the children. 

Pedagogists who are in charge of our school systems 
are frequently not even informed as to the extent of re- 
tardation existing in their own districts, unless the facts 
and figures regarding it are brought before them by outside 
agencies; and legislators are either too ill-informed to deal 
with the question or too indifferent to give it their attention. 

The medical profession must bear the responsibility 
of a great part of this ignorance. Parents should know 
something of anatomy and physiology, of hygiene and die- 
tetics, and of the causes and results of common diseases. 
Teachers should be capable of recognizing physical abnor- 
malities, of understanding their effect upon the child, and 
of applying such material, psychologic or pedagogic reme- 
dies as fall within their province. Who but our physicians 
can impart this knowledge? It is the medical adviser who 
is best suited to inform parents of the vital problems they 
are called upon to meet, and to instruct teachers so that 
they may co-operate efficiently with parents in making the 
home life and school life of the child equally effective. This 
duty should not be passively performed, but should take 
the place of an active educational campaign. And yet how 
many physicians not only fail to do this, but are actually 
lacking in the knowledge necessary to do it. 

A serious, indeed a vital, error underlies the whole of 
this ignorance. It is the error of misconceiving and mis- 
understanding the real child nature. A child is not a 
machine; he is not a mere protoplasmic test-tube, within 
which numerous physical and chemical reactions are con- 
tinually going on. Pie is a living thing, a human being, 
a body within which burns a spark of the Divine Fire. He 
has a personality, a soul. Perhaps you will call this un- 

* Ibid., p. 80. 

99 



scientific, imaginative, fantastic. But my conviction is pro- 
found that if the belief in personality within the physical 
body were firmly rooted in the minds of our physicians and 
other scientists — as in fact it is fast becoming rooted in the 
minds of our philosophers — and if this belief were im- 
parted to parents, teachers and others concerned in the 
welfare of the child, a great change would take place in 
our educational system. We are in the habit of speaking 
of mentally defective children as if the real mind of the 
child were at fault. But in this we are placing the emphasis 
on the wrong side. The defect should be sought in the 
body, not in the mind ; it will be found in the injured cor- 
tex, the undeveloped association fibres, the broken axis- 
cylinders, the blighted sensory organs, or the weak meta- 
bolic processes, and not in the higher fac^ulties — those fac- 
ulties which compose the personality. A viewpoint such as 
this would make it evident that there is something worth 
reaching within the shell of physical defects and moral 
obliquity, and this knowledge would act as a powerful in- 
centive to better care and more persistent training. It would 
make us realize that nearly all retardation is due either to 
physical defect or- to poor teaching. 

We need organized and systematic instruction of 
parents by physicians. Thousands of children might be 
spared the handicap of defective bodies and untrained minds, 
the hardship of custodial life, or the disgrace of a prison 
sentence by such instruction. 

We need really practical courses in physiology, psy- 
chology, hygiene, etc., conducted by able physicians, in the 
curricula of our normal schools. 

We need experimental laboratories in connection with 
our public school systems, in charge of fully trained per- 
sons, competent to examine children who deviate from the 
normal work or progress of the regular grades, and to 
plan and execute efficient special methods of training to 
correct this deviation. We cannot expect results without 

100 



this. What can a teacher with a simple normal training 
accomplish, who is turned loose in a large room with thirty 
so-called backward children and merely told that she may 
have double time to teach them? 

We need better taught and wider read physicians, who 
will not overlook deafness or adenoids, who will not make 
light of fever and convulsions, who will not fail to recog- 
nize microcephalus or thyroid defect, and who will not turn 
subnormal children out-doors to run wild, with the assur- 
ance that they will be "all right in a year or two." 

Above all we need a more optimistic spirit, a more 
afilirmative point of view in handling our exceptional chil- 
dren. There is too much of a tendency to pronounce diffi- 
cult cases hopeless, and to pack them off to the custodial 
schools. This is little short of criminal. If a -small part 
of the money that is spent in caring for these children were 
expended in devising suitable methods for training them, 
they would never need to be sent to an institution. This 
has been demonstrated repeatedly in our own school. I 
have in mind a microcephalic girl of mild type whose 
parents, beHeving her trouble incurable, kept her at home. 
All efforts to train her failed. She did not learn even a 
single letter of the alphabet. When she reached the age of 
fourteen years she was sent to us, and by utilizing methods 
devised especially to meet her needs, we were able in five 
years to teach her how to read, write, and attend to prac- 
tically all the domestic and social duties that a girl of 
nineteen should perform. She is now capable of taking a 
place in her family. There are hundreds of such cases 
in our institutions at the present time who could have been 
spared custodial life if they had not been pronounced 
hopeless. 

This wrong viewpoint is illustrated by an article pub- 
lished in one of the current popular magazines. The great 
good that this article might do is without doubt seriously 
handicapped by the fact that the writer discriminates 

lOI 



between backward children and those whom she is thought- 
less and unkind enough to call ''idiots" and ''imbeciles." 
She believes that a look at the face will tell the psycholo- 
gist that there is no mind to do anything with, and that 
the case is consequently hopelessly incurable. To any one 
who has studied children with the more serious forms of 
defect and has seen what wonderful improvement some- 
times results in apparently difficult cases, this viewpoint 
is absurd. Articles of this kind undoubtedly cause much 
unnecessary pain and discouragement to many mothers. 

If the influence of the American Academy of Medi- 
cine were exerted to arouse among physicians an active 
interest in the proper instruction of all who have in charge 
the care and upbringing of children, a movement could be 
started, the value and good effect of which can hardly be 
estimated. The people need to be taught the truth about 
these things, and the opportunity to give such instruction 
is in the hands of the medical profession. When adequate 
knowledge has been imparted, the work of stopping the 
leakage in our educational system will be an easy task, for 
enlightened pubHc opinion is all-powerful. 



102 



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